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An introduction to articles in the issue is presented on topics including description of a free neurorehabilitation clinic staffed by volunteers to fill the gap for people with physical, cognitive, and communication disorders, concussion recovery as a dichotomous state, and how and why we do what we do in clinical practice.

An introduction to articles in the issue is presented on topics including description of a free neuro-rehabilitation clinic staffed by volunteers to fill the gap for people with physical, cognitive, and communication disorders, concussion recovery as a dichotomous state, and how and why we do what we do in clinical practice.

Purpose: The purpose of this clinical focus article is to summarize a community discussion about the practical implementation of recommended vocal function measures by practicing speech-language pathologists specializing in the treatment of voice and upper airway disorders, review common barriers and challenges to implementation, and suggest opportunities for further education and discussion. Method: An online discussion was held with members of American Speech- Language-Hearing Association Special Interest Group (SIG) 3 to facilitate discussion regarding participants' experiences implementing vocal function assessment (acoustic and aerodynamic assessment) in their practice settings. The discussion was based on the expert panel consensus paper by Patel et al. (2018), which provided recommendations for a minimum core set of vocal function measures. Results: Discussion topics included standardization methods, environmental factors, preferred hardware and software, tasks and measures, interpretation, and infection control. Participants reported that the recommendations of the consensus paper provide a useful guideline for obtaining a core set of reliable and valid measures. They also reported facing barriers in meeting these recommendations due to varying practice settings and resources. Conclusions: Variations in instrumental assessment may arise due to differences in clinic models, testing environments, accessible equipment, allotted time, and clinician opinion. During the discussion, participants emphasized the need for further education and discussion on the implementation of vocal function assessment, particularly regarding adaptations for different clinical models, low-cost and low-tech alternatives, synthesis of findings, and the relevance of additional or omitted measures in specific situations. To address these concerns, it is recommended that the SIG 3 community delve deeper into this topic, open additional discussion about various topics cited as barriers to vocal function assessment implementation, and create ongoing educational opportunities for clinicians, especially for those who lack access to a voice-specialized clinical fellowship program or mentorship by a specialized clinical expert. [ABSTRACT FROM AUTHOR]

Purpose: School-based speech-language pathologists (SLPs) face uniquely complex webs of guidelines and criteria that can undermine their ability to move toward disability-affirming practices. The purpose of this clinical focus article is to present a contrast between ableist and disability-affirming practices in school-based stuttering therapy while highlighting the critical perspectives of students who stutter. Practical examples of disability-affirming stuttering therapy in public school settings are provided. Conclusions: This clinical focus article outlines practical guidelines and specific examples of affirming collaboration, eligibility decisions, goal choice, and accommodations for students who stutter. These discussions demonstrate how SLPs can adopt updated assessment therapy planning and institutional practices to affirm students who stutter while informing school cultures and society about the dignity and value of stuttered voices. [ABSTRACT FROM AUTHOR]

Purpose: Language Impairment Testing in Multilingual Settings (LITMUS) instruments were developed to improve the identification of developmental language disorders in multilingual children. The current study investigated the usability and feasibility of the online Dutch version of several of these instruments (LITMUS-NL) according to speech-language pathologists (SLPs), thereby taking the first steps toward implementation in clinical practice. Method: We first conducted a usability study in which 24 SLPs performed the LITMUS-NL tests while using a think-aloud protocol. They subsequently filled out a questionnaire to investigate the degree of usability and added value of LITMUS-NL. After adapting LITMUS-NL based on the results of the usability study, a feasibility study was carried out in which 25 other SLPs each used LITMUS-NL with three multilingual children. Afterward, they completed a feasibility questionnaire and questionnaires about the reactions of the children. Results: In the first study, many usability issues emerged, mainly concerning technical problems, instructions, and test construction. Despite these issues, the SLPs evaluated the degree of usability and added value as positive. The feasibility study revealed a lower degree of usability and, despite the adaptations, feasibility issues in the same categories. Conclusions: By involving the intended users in the process toward implementing a new product, we identified (and solved) many issues that would interfere with successful implementation in daily clinical practice. A systematic, iterative approach toward implementation helps identify what is deemed important by the intended users of a new product and bridges the gap between research and practice. [ABSTRACT FROM AUTHOR]

Purpose: We provide a case report of "Zoe," a 4-year-old deaf child from a deaf signing family, who presented with a possible case of Childhood Apraxia of Sign (CASign). Method: The description is based on reports from the child's speech-language pathologist, her Individualized Education Program report, and a clinician-created sign imitation task. Results: Zoe's sign articulation errors in American Sign Language differed from those reported for typically developing deaf children and were parallel to the types of errors observed for hearing children with childhood apraxia of speech. Specifically, Zoe produced inconsistent errors across signs, substituted more complex handshapes for simple handshapes, made errors on both unmarked (common) and marked (less common) forms, produced articulatory distortions (rather than substitutions), and exhibited "groping" behaviors (a sequence of attempts to move her hands into the correct position). In addition, Zoe sometimes self-corrected her errors by manipulating her own hands, for example, using her left hand to move the thumb of her right hand into the correct position. Conclusion: Zoe's pattern of sign errors is consistent with an underlying deficit in motor planning and/or programming and may constitute the first reported case of CASign. [ABSTRACT FROM AUTHOR]

Purpose: Advancements in genetic testing and analysis have allowed improved identification of the genetic basis of childhood apraxia of speech, a rare speech presentation. This study aimed to understand speech-language pathologists' (SLPs') consideration of incorporation of genetics in clinical practice using a theory-informed qualitative approach. Method: Semistructured interviews were conducted with 12 pediatric SLPs using a behavior change theory (Theoretical Domains Framework [TDF]) within a case study describing a child with complex co-occurring features, including childhood apraxia of speech. Interviews focused on three stages of the patient journey (prereferral, referral, and postreferral). Interviews were analyzed to identify barriers and enablers to considering incorporation of genetics in current clinical practice. Barriers and enablers were grouped and mapped onto a contextually relevant TDF-coded analysis framework. Results: Barriers were identified across several TDF domains, through all stages of the patient journey. Lack of confidence, relevance, and level of experience were most common prereferral, and connection to and awareness of genetics services and contextual factors were barriers in the referral stage. Perception of professional role, knowledge, and beliefs about effects on families were barriers postreferral. Associated enablers were also identified, including seeing value in genetic diagnosis, support from other health care professionals, supervision, and relationships with genetics services. Conclusions: Results of this qualitative study highlight barriers and enablers to incorporating genetics into speech-language pathology clinical practice. These findings will assist in the development of theory-informed implementation strategies to support SLPs into the future. [ABSTRACT FROM AUTHOR]

Purpose: The current standard for clinical diagnosis of childhood apraxia of speech (CAS) is expert clinician judgment. The psychometric properties of this standard are not well understood; however, they are important for improving clinical diagnosis. The purpose of this study is to determine the extent to which experts agree on the clinical diagnosis of CAS using two cohorts of children with mixed speech sound disorders (SSDs). Method: Speech samples of children with SSDs were obtained from previous and ongoing research from video recordings of children aged 3-8 years (n = 36) and audio recordings of children aged 8-17 years (n = 56). A total of 23 expert, English-speaking clinicians were recruited internationally. Three of these experts rated each speech sample to provide a description of the observed features and a diagnosis. Intrarater reliability was acceptable at 85% agreement. Results: Interrater reliability on the presence or absence of CAS among experts was poor both as a categorical diagnosis (κ = .187, 95% confidence interval [CI] [0.089, 0.286]) and on a continuous "likelihood of CAS" scale (0-100; intraclass correlation = .183, 95% CI [.037, .347]). Reliability was similar across the video-recorded and audio-only samples. There was greater agreement on other diagnoses (such as articulation disorder) than on the diagnosis of CAS, although these too did not meet the predetermined standard. Likelihood of CAS was greater in children who presented with more American Speech-Language-Hearing Association CAS consensus features. Conclusions: Different expert raters had different thresholds for applying the diagnosis of CAS. If expert clinician judgment is to be used for diagnosis of CAS or other SSDs, further standardization and calibration is needed to increase interrater reliability. Diagnosis may require operationalized checklists or reliable measures that operate along a diagnostic continuum. Supplemental Material: https://doi.org/10.23641/asha.23949105 [ABSTRACT FROM AUTHOR]

Purpose: Effective communication between nonspeaking patients and providers is critical for the quality of care in intensive care units (ICUs). This study aims to evaluate perspectives of health care providers and nonspeaking patients on effective communication and communication barriers in the ICU. Method: Qualitative and quantitative survey methodologies were employed to evaluate providers' and patients' perspectives on effective communication. Rating scales were utilized to measure patients' frustration levels and communication effectiveness. Open-ended questions were employed to reflect on barriers to communication in the ICU, instances of ineffective communication, and recommendations for enhancing effective communication. Results: The results of the study suggest that nonspeaking patients experienced high levels of frustration due to ineffective communication. However, the data reveal that access to appropriate augmentative and alternative communication (AAC) strategies and materials could help mitigate patients' frustration. Providers mainly communicated via asking yes/no questions, which largely limited the information patients conveyed, leading to frequent communication breakdowns. Providers expressed a desire to participate in training programs to utilize appropriate AAC strategies and promote effective communication. Conclusions: This study provides preliminary survey results on perspectives of patients and providers on effective communication in the ICU. Both providers and patients reported experiencing challenges and frustration during their communication, due to barriers such as providers' insufficient training experience and lack of access to AAC materials. Skill training is warranted to promote effective patient-provider communication in intensive care settings. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this investigation was to evaluate language development and disorders course titles across communication sciences and disorders (CSD) graduate programs in an effort to determine whether adolescents were specifically being recognized via inclusive language or dedicated courses. The findings can be used to propel important discussions about the need for inclusive course titles, inform initial directions for improvements in preprofessional education, and guide broader changes in the discipline, especially for the adolescent population. Method: A review of accredited CSD graduate programs across the United States was conducted using the American Speech-Language-Hearing Association EdFind database. A total of 298 master's-level CSD programs were used for this study. CSD course titles located in each of the university's graduate catalogs were documented, categorized, and reviewed by the research team. Results: Of the 298 CSD graduate programs reviewed, one in eight specifically included the word "adolescent(s)" or "adolescence" in the titles of their language development and disorders courses. Remarkably, only four adolescentfocused courses, two of which were listed as electives, were offered across all reviewed programs. A post hoc analysis of the language used in course titling revealed that 42 titles used inclusive terminology. Conclusions: Adolescents are developmentally distinct from children, yet a majority of CSD graduate programs used ambiguous or exclusive words in the titles of their language development and disorders courses. The unintentional failure to recognize this important difference in course titles may be contributing to the ongoing neglect of adolescents within the field. Reframing collective thinking is required for change. Reasons and suggestions for including adolescents in course titles and separate offerings are provided to assist CSD graduate programs in leading the way toward improving equity for adolescents. [ABSTRACT FROM AUTHOR]

Purpose: This article reviews the literature focused on the psychological effects of craniofacial care for patients and their families. It provides an overview of pediatric medical traumatic stress (PMTS) associated with craniofacial conditions and related care, along with a review of its risk and protective factors. Findings from studies of PMTS in craniofacial populations are also reviewed. Conclusions: The article concludes with strategies for identifying, addressing, and preventing medical traumatic stress in the context of craniofacial care. Specific implications for speech-language pathologists are also shared with respect to ways of minimizing risks for medical traumatic stress in craniofacial care. Future directions are also delineated and include strategies to improve screening and support for patients with craniofacial conditions and their families, along with the development of interventions aimed at increasing resilience. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate the attitudes of speech-language pathology--related specialists (SPs) and speech-language pathology (SLP) students toward stuttering. Furthermore, we identified the factors that influence changes in the attitudes of SLP students and SPs in various countries. Method: Using a search formula, the PubMed and ScienceDirect databases were used to conduct primary and secondary screening for analysis. All previous studies included in the systematic review focused on SPs or SLP students and were published in English. Studies were collected and screened independently by the first and second authors and then discussed between them. Twenty-two studies with varying research designs and sample sizes were included in the systematic review. Finally, information on authors, publishing year, participant, country or region, assessment materials, and the results were extracted and organized before analysis. Results: Twenty-two articles from eight countries and one region (Middle East) were extracted. The results showed that SLP students and SPs in different countries have different attitudes toward stuttering depending on their education, experience, geographic location, cultural status, and societal development, but stereotypes of people who stutter (PWS) persist (e.g., nervous), and the attitudes toward the clinics appear to be more negative in Western countries. Conclusions: Negative attitudes toward PWS remain among both SLP students and SPs. Thus, the factors that may influence the attitudes of SLP students and SPs should be taken into account in academic and clinical education in fluency disorders, and the education content must be structured to improve the quality of education and the attitude toward PWS. [ABSTRACT FROM AUTHOR]

Purpose: Across Canada, speech-language pathologists (SLPs) and educational psychologists (EPs) work in schools to identify and diagnose childhood learning difficulties, including language disorders; however, both professional groups use different terms to identify and diagnose them. Using the term developmental language disorder (DLD), developed by the CATALISE consortium, would provide consistency across fields. To effectively implement the use of DLD, it is crucial to understand how EPs and SLPs currently identify childhood language disorders and to investigate the potential impact of a practice change in this area. Method: The study conducted 13 moderated focus groups and one one-on-one semi-structured interview across six Canadian provinces in English and French. Results: We found some social and structural barriers that impact SLPs’ and EPs’ current practice of identifying and diagnosing language disorders generally (e.g., the belief that children should not be labeled “too early,” institutions that prioritize certain professional diagnoses over others, board policies that do not allocate funds for language disorders, professionals’ reticence to convey difficult information such as a diagnosis to collaborators) and DLD specifically (e.g., different professional taxonomies, lack of familiarity with or uncertainty about the label, not recognized as a condition in schools that may or may not even identify language disorder as a category of exceptionality). Nevertheless, the focus groups also revealed the extent to which DLD could be useful in their current practice. Conclusion: Both EPs and SLPs acknowledged the importance of working together; therefore, DLD could inspire more collaborative practice between SLPs and EPs around language disorders. [ABSTRACT FROM AUTHOR]

Purpose: This quality improvement project aimed to address the inconsistent use of clinical labels across a preschool speech and language program in Ontario, Canada. The study investigated whether a multicomponent knowledge translation (KT) intervention could increase speech-language pathologists’ (SLPs’) knowledge about the recommended clinical labels, motivate their intentions to use the labels, and facilitate practice change during a 3-month pilot period. Method: The diffusion of innovations theory was utilized to identify and address known and suspected barriers and facilitators that could influence the adoption of consistent terminology. The intervention was evaluated using a pre-experimental study design (with pre, post, and follow-up testing) and included two phases: Phase 1 involved the pretraining survey, KT intervention, and post-training survey, and Phase 2 included an exit survey after a 3-month pilot period. Results: Five hundred twenty-nine SLPs in Phase 1 and 387 SLPs in Phase 2 participated. Following the web-based intervention, SLPs demonstrated improved knowledge about the recommended labels with most indicating intentions to communicate the labels going forward. SLPs also reported increased comfort using labels and positive views on their importance and value. After the 3-month pilot period, SLPs’ reported use of most recommended labels decreased, as did ratings of comfort, value, and importance. However, most SLPs reported intentions to use the labels going forward. Conclusions: Despite having intentions to adopt the recommended labels, the lack of implementation by SLPs suggests the presence of additional barriers impacting their use of the recommended clinical labels in practice. Future work should investigate clinician-identified barriers to inform future implementation efforts. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to identify training gaps and continuing education (CE) needs for speech-language pathologists (SLPs) in evaluating and treating children with cleft palate across and among areas of varying population density. Method: An anonymous 35-question survey lasting approximately 10-15 min was created in Qualtrics based on a previously published study. The survey information and link were electronically distributed to American Speech-Language-Hearing Association (ASHA)-certified SLPs through ASHA listservs, social media, individual-state SLP organizations, and an e-mail list of publicly listed SLPs. A total of 359 survey responses were collected. Results: Respondents varied in terms of age, type of certification, practice location, and clinical experience with cleft palate, with the largest percentage (46.7%) of respondents in a school-based setting. Only 28.5% reported currently feeling comfortable treating children with cleft palate. Respondents reported conventions/conferences (25.4%) and webinars (23.2%) were the most helpful resources, but DVDs were frequently not used for CE. Information from the child's cleft team (84.4%) and mentors/colleagues (70%) were considered high-quality resources. Respondents indicated information on treatment of articulation (79.2%) and resonance (78.4%) disorders as well as specific therapy techniques (76.9%) would be very helpful for clinical practice. Population density significantly influenced how respondents ranked the perceived helpfulness and quality of different resources as well as desired topics for future resources. Conclusions: There is a continued need for adequate training and CE opportunities for SLPs, particularly related to assessing and treating children with cleft palate. Increased access to high-quality CE resources will be key to filling educational gaps present for SLPs, especially in areas of low-population density. [ABSTRACT FROM AUTHOR]

Purpose: Family--professional partnerships are important for youth learning to use aided augmentative and alternative communication (AAC). This study examined the family-oriented beliefs and practices of speech-language pathologists (SLPs) working with preschool and school-aged children learning to use aided AAC (aged 3--21 years), specifically during the COVID-19 pandemic. Method: Participants were 25 SLPs who participated in an individual semistructured interview. Qualitative analysis was used to identify and describe groups of SLPs based on commonalities and differences in their beliefs and practices working with families. The characteristics of SLPs in each group was also explored descriptively (e.g., race/ethnicity, work setting, caseload). Results: SLPs clustered into three groups based on their beliefs and practices: (a) professionally centered, (b) family-allied, and (c) family-focused. SLPs varied across these groups in how they planned services, offered training/coaching, communicated, shared resources, offered emotional support, and adapted to and with different families. Conclusions: Findings indicate the need to support greater family-centeredness in AAC services by building on the strengths of SLPs in the field. Promoting strong family--professional partnerships could in turn improve outcomes for students who use AAC. [ABSTRACT FROM AUTHOR]

Purpose: This study had two aims. Aim 1 was to query both communication science and disorders (CSD) faculty and school-based speech-language pathologists (SLPs) regarding how written language is/was covered in their graduate programs. Aim 2 was to query school-based SLPs about their written language service provision. Method: CSD faculty (n = 143) and school-based SLPs (n = 610) completed an online survey examining (a) if and how written language was addressed in their graduate program, (b) what content related to written language was covered in graduate school, and (c) provision of written language services in schools (SLPs only). Results: There was a discrepancy in reports of training provision. Faculty reported providing more training than SLPs reported receiving. However, SLPs with fewer years of experience reported slightly higher levels of training compared to those with more years of experience. Additionally, there was variability among SLPs in how often they targeted written language in therapy. Finally, receipt of training in written language was a significant predictor of provision of written language services, as reported by SLPs. Conclusions: SLPs play a key role on literacy teams in schools, but many SLPs did not receive adequate training in written language. In order to ensure SLPs are trained to work with children with reading difficulties, graduate programs should ensure that written language is part of the clinical and academic curricula. [ABSTRACT FROM AUTHOR]

Purpose: This clinical focus article will provide an overview of the psychosocial impact of aphasia, with particular attention to depression and anxiety and barriers for accessing mental health services. The importance of interdisciplinary collaboration between speech-language pathologists (SLPs) and mental health providers as well as importance of stepped psychological care, peer befriending, support groups, and communication partner training will be highlighted. Resources will be provided for clinicians to utilize in increasing their knowledge and skills in supporting psychosocial issues for people with aphasia and their families. Conclusions: People living with aphasia are at high risk of mental health problems. There is a gap in the need for services and access to services due to the inherent language challenges caused by aphasia. SLPs need to take a leadership role in bridging this gap by partnering with mental health providers to increase access to services. Using the framework of stepped psychological care, SLPs can support people living with aphasia and their families in successfully living with aphasia. [ABSTRACT FROM AUTHOR]

Purpose: The COVID-19 pandemic caused significant changes for family-- professional interactions. Many services shifted to telepractice, with new opportunities for parents and speech-language pathologists (SLPs) to partner for service delivery. Parent-coached models of augmentative and alternative communication (AAC) intervention provide positive outcomes for children; however, SLPs have reported difficulty building strong partnerships with families. The shift to telepractice during the COVID-19 pandemic provided a unique context to examine factors influencing parent--SLP partnerships, particularly for parents with children who use aided AAC. Method: Twenty-five parents and 25 SLPs who engaged in services with children and youth from 3 to 21 years of age who used aided AAC during the initial stages of the COVID-19 pandemic in June 2020 participated. Semistructured interviews were conducted individually with parents and SLPs to understand perspectives on whether the change in service delivery facilitated or hindered family-oriented practice. Inductive qualitative analysis was used to analyze information about the factors impacting parent--SLP partnerships. Results: The parent--SLP partnership was influenced by setting and systemic determinants, and intrinsic determinants to the parent and the SLP that included their history and rapport, beliefs about partnering, and knowledge and skills. These determinants served as barriers or facilitators to their partnership. Conclusions: It is essential to consider the relationship, expectations, and knowledge and skills that SLPs and parents bring to the partnership, along with extrinsic structural factors that can impact this partnership. Positive rapport, valued partnership, and an openness to sharing knowledge through teaming and collaboration provided for positive parent--SLP partnerships. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to examine school-based speech-language pathologists' (SLPs') implementation of services to address students' executive function (EF) needs, with particular emphasis on the prevalence and characteristics of EF interventions and the factors and barriers that influence service provision for students with EF needs. Method: We applied an explanatory sequential mixed-methods research design, beginning with a quantitative survey followed by a series of qualitative interviews. We analyzed the survey results using descriptive data and binary logistic regressions and used the emergent trends to inform our interview protocol, so that we could explore those trends in greater detail and context. We synthesized our quantitative and qualitative data to evaluate the characteristics of EF interventions and the factors influencing services. Results: Most SLPs reported that they addressed their students' EF needs through some sort of direct or indirect intervention. Direct interventions varied by targeted domain, service delivery setting, and teaching techniques, though most SLPs favored strategy instruction and highly contextualized services. Indirect services included accommodations and consultation. SLPs commonly reported the lack of collaborative support, time, and knowledge as barriers, and most reported that professional development would be helpful to improve their services. Conclusions: Speech-language pathology graduate programs and providers of professional development should be mindful of their role in preparing SLPs to address EF needs, while SLPs may use these results to inform their own practice. Further guidance and research are necessary to elucidate the SLPs' role in mitigating the negative impact of EF challenges on students' education. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this exploratory study was to evaluate speech-language pathologists' (SLPs') conceptions and misconceptions about dyslexia. Method: Participants were 86 school-based SLPs. They completed an online survey on which they rated their agreement and disagreement with true and false statements related to the scientific evidence about the nature of dyslexia and interventions for dyslexia, as well as common misconceptions about dyslexia. Results: There was considerable variability among SLPs' agreement and disagreement with the statements. Critically, despite abundant contrary evidence in the literature, many SLPs believe that dyslexia involves a visual processing deficit. Conclusions: These findings suggest that many school-based SLPs hold misconceptions about dyslexia, especially those related to dyslexia being a visual disorder. The identified misconceptions may contribute to some SLPs' reluctance to incorporate reading and prereading skills into speech-language assessment and intervention. SLPs need greater knowledge of dyslexia to provide more effective evaluations and intervention services. [ABSTRACT FROM AUTHOR]

Purpose: Speech-language pathologists (SLPs) have multiple roles and responsibilities related to language and literacy instruction in schools. The purpose of this exploratory, qualitative study was to analyze school-based SLPs' perceptions related to effective language and early literacy instruction for pre-K children with developmental language disorder (DLD). The goal of this study was to inform development of a new language and early literacy professional development program for inclusive pre-K teachers. Method: Eight school-based SLPs participated in a 1-hr virtual focus group conducted via Zoom recording technology. The researchers used a conventional content analysis approach to analyze the focus group data and identify themes from the discussion. Results: The researchers developed two themes: (a) SLPs identified repeated exposure to books, peer interaction, and teaching vocabulary with visual supports and props as key elements of language and literacy instruction that can be integrated into a variety of contexts, and (b) SLPs want more time with parents and teachers to support their book reading and model specific language strategies. Conclusions: SLPs identified several instructional practices inclusive pre-K teachers could be taught to use during professional development programs to support the emergent literacy development of children with DLD. They also discussed the need for ongoing collaboration between SLPs, caregivers, and teachers to maximize children's early language and literacy experiences. Future research should explore the impact of partnerships with caregivers and teachers on children's language and literacy outcomes. [ABSTRACT FROM AUTHOR]

Purpose: This scoping review aimed to explore the extant literature on the experiences and views of speech-language pathologists (SLPs) and SLP students regarding the provision of care to people living with dementia (PLWD). Method: A systematic search was conducted using 10 databases for sources published in English from January 2000 through January 2022. Sources were included if participants were practicing SLPs and/or students enrolled in undergraduate communicative disorders or graduate SLP programs and if the concepts of experiences or views on the provision of SLP services to PLWD were explored in the context of any clinical or educational setting. Included sources were systematically extracted for pertinent study characteristics, including SLP roles and settings, concept domains, measures utilized, and facilitators/barriers to effective dementia care. Results: The majority of the 29 included sources were published in either academic journals (n = 20) or professional organization publications (n = 5) and used a cross-sectional study design (n = 19). Participants included SLPs (n = 22 studies) and graduate (n = 6 studies), undergraduate (n = 3 studies), and doctoral students (n = 1 study). The included studies addressed five primary conceptual domains: experiences, attitudes, roles, knowledge, and confidence. The most commonly addressed barriers and facilitators of effective dementia care were education and training. Conclusions: Mapping and analysis of the current body of knowledge within this scoping review illuminated several knowledge gaps that we propose need to be addressed to meet the education and training needs of SLPs to provide optimal care to PLWD. These include systematically measuring access to and outcomes of evidence-based education and training programs both within and outside of an interprofessional collaborative context. [ABSTRACT FROM AUTHOR]

Purpose: Supporting autistic speech-language pathologists (SLPs) is critical to expanding diversity within the field of speech-language pathology. The purpose of this study is to better understand how autistic SLPs reconcile tensions between their personal and professional experiences and negotiate the intersection of these identities. Method: Five certified SLPs, each of whom had a formal autism diagnosis or self-identified as autistic, engaged in a one-on-one semistructured conversation. The recorded interviews were transcribed manually. Following grounded theory analysis, multiple levels of coding were performed to construct a theoretical interpretation of the data. Results: Four themes arose from the analysis. In the first, participants described their outlooks on their autistic identities and how these have changed over time. The second theme concerns interpersonal tensions and conflicts related to communication differences across neurotypes. In the third, participants reflected on the stigma and ableism they face in their careers, and concerns about disclosing their autistic identity in the workplace. The fourth comprised participants' neurodiversity-affirming approaches to clinical practice with autistic clients. Conclusions: This study represents a first step toward understanding the unique strengths of autistic SLPs and the challenges they face. They can be better supported throughout their education, training, and careers. Our field must embrace and promote the neurodiversity paradigm to truly support all our colleagues and clients. [ABSTRACT FROM AUTHOR]

Purpose: This study examined public school (PS) speech-language pathologists’ (SLPs’) perceived confidence in managing pediatric feeding disorders (PFDs). Perceived confidence is a rater’s self-reported assurance level to manage PFDs. The study then looked for relationships between personal and professional factors that might account for perceived confidence. Geographic location as well as administrative supports and resources were also examined. Method: Participants were PS SLPs from across the United States who were recruited via American Speech-Language-Hearing Association Special Interest Groups. This study measured perceived confidence with a 5-point Likert-type scale for 17 roles and responsibilities in PFD management. Pearson and Spearman correlations were used to identify relationships with personal and professional characteristics. Results: PS SLPs perceived themselves as having low confidence in managing PFDs. Personal and professional characteristics account for low perceived confidence (e.g., number of graduate courses, clinical experience with swallowing and feeding in early intervention or medical settings, managing swallowing and feeding currently, having more administrative support). Conclusions: This study provided a more representative sample (i.e., geographic regions) of PS SLPs. Perceived confidence in PFD management is linked to factors that can be modified through personal and professional changes. [ABSTRACT FROM AUTHOR]

Purpose: Ultrasound biofeedback therapy (UBT) is a relatively new type of technology-assisted speech-language therapy and has shown promise in remediating speech sound disorders. However, there is a current lack of understanding of the barriers and benefits that may influence the usage behavior and clinical decision making for the implementation of UBT from a clinician perspective. In this qualitative study, we explore the perspectives of speech-language pathologists (SLPs) who have used ultrasound biofeedback in programs of speech sound therapy using the unified theory of acceptance and use of technology (UTAUT) model. Method: Seven SLPs who had clinical experience treating speech sound disorders with UBT participated. Semistructured in-depth interviews were conducted and video-recorded. Two coders coded and categorized the transcribed data, with consensus established with a third coder. Using thematic analysis, the data were exploratorily grouped into themes along components of the UTAUT model. Results: The highest number of codes was sorted into the “effort expectancy” theme, followed by “performance expectancy,” “social influence,” and “facilitating conditions” themes of the UTAUT model. Clinicians identified multiple perceived barriers and benefits to the use of ultrasound technology. The top identified barrier was limited accessibility, and the top benefit was the ability to visualize a client’s articulatory response to cues on a display. Conclusions: Clinicians prioritized “effort expectancy” and “performance expectancy” when reflecting on the use of ultrasound biofeedback for speech sound disorders. Clinicians spoke favorably about using UBT for speech sound disorder treatment but acknowledged institutional barriers and limitations at organizational and social levels. [ABSTRACT FROM AUTHOR]

Purpose: We explore the extent to which speech-language pathologists (SLPs) are operating under assumptions about speech, language, and literacy that are not supported by evidence or are contradicted by evidence. Method: SLPs (N = 106) marked the degree to which they endorsed or rejected four true and 11 myth (i.e., false) statements on a visual analog scale via an online survey. We analyzed the degree to which participants agreed or disagreed with these statements related to speech, language, and literacy development and impairment. Results: Based on results of one-sample t tests, participants as a group correctly rejected seven myth statements and correctly endorsed three true statements. Participants as a group provided equivocal responses to the remaining four myth statements and one true statement. Scores for each statement spanned all or nearly all of the possible range. Even when participants overall showed relatively strong disagreement with a particular myth statement, at least a few participants endorsed the myth statement. Conclusions: The findings indicate areas of relative strength for SLPs’ knowledge of current evidence for augmentative and alternative communication, bilingualism, and language input that supports language development. Identified areas of relative weakness include knowledge of the expected grammatical and speech production skills of children with typical development and the influence of ear infections in childhood on language impairment. Additional research is needed to evaluate efforts to enhance SLPs’ knowledge and use of evidence-based practices. [ABSTRACT FROM AUTHOR]

Purpose: Administrative support and accurate perceptions are believed to facilitate the use of speech-language services that are integrated into the classroom (i.e., integrated classroom-based services [ICBS]). The purpose of this study was to compare elementary principals' and speech-language pathologists' (SLPs') perceptions of ICBS in three areas: (a) effectiveness and benefits, (b) impact of the SLP--teacher relationship, and (c) need for administrative support. Method: This study used a web-based survey to investigate Ohio elementary SLPs' and principals' perceptions of ICBS. Demographic information was collected, and participants were asked to state their level of agreement on 17 perception statements using a 5-point Likert scale. Two hundred and ten SLPs and 89 principals participated in the study. Results: Data showed that SLPs and principals held similar perceptions about the overall effectiveness of ICBS, the need for a positive SLP--teacher relationship, the importance of adequate administrative support, and several key benefits. Differences occurred on statements related to targeting speech goals, behavior management, student grouping, and data collection. Conclusions: SLPs and principals generally held more similar than different perceptions about ICBS. Where differences existed, it was recommended that SLPs work with principals to obtain professional development, implement caseload management strategies, and remove barriers that hinder the implementation of ICBS. The efforts may lead to the increased use of ICBS for elementary school--age children with speech-language impairments. [ABSTRACT FROM AUTHOR]

Purpose: This mixed-methods study aimed to obtain information regarding speech-language pathologists' (SLPs) perspectives about treatment of lateralization errors (LEs), challenges to implementing evidence-based LE treatment practice, and the sources SLPs' use to find evidence to treat LEs. This information can assist our understanding of ways to facilitate the uptake of evidencebased practice into the everyday treatment of clients with this disorder. Method: A convergent parallel mixed-methods design was used to collect data from SLPs (N = 214) using 24 questions from an online survey distributed through electronic mailing lists and Speech and Hearing State Associations. Quantitative data were analyzed using frequencies and averages; themes and subthemes of qualitative data were analyzed using a content analysis approach with no a priori codes. Quantitative and qualitative results were compared and integrated. Results: Participants believed that LEs required individualized treatment before the age of 5 years, were largely caused by structural and neuromuscular factors, and required an understanding of orofacial and dental structure and function. Challenges to implementing LE treatment included a lack of skills and knowledge specific to LEs, competing demands on clinicians' time and resources, and a research-practice gap. Sources of evidence frequently used to obtain information about LE treatment were colleagues, trainings, workshops, and American Speech-Language-Hearing Association journals. Conclusions: Clinicians believe that LE treatment is challenging and requires skill training. Future research in LEs will need to consider the real-world decisions clinicians must make when treating this disorder as well as clinicians' everyday constraints and challenges. [ABSTRACT FROM AUTHOR]

Purpose: This survey examines the practice patterns of speech-language pathologists (SLPs) when recommending thickened liquids as part of dysphagia management. It also surveys SLPs' knowledge and learning methods about thickening agents and factors contributing to quality control in service delivery such as staff instruction and familiarity with measurement tools to verify level of texture consistency. Method: The electronic survey was posted to the community groups for SLP Health Care and Special Interest Group 13 Swallowing and Swallowing Disorders (Dysphagia) of the American Speech-Language-Hearing Association given that their members included professionals with interest and experience in dysphagia management. Results: A total of 246 SLPs, primarily with an adult emphasis in dysphagia management, provided survey responses. Respondents generally viewed the use of thickened liquids as a short-term intervention and self-reported that nectar-like (mildly thick) represented their most recommended level of texture modification. Although SLPs' perceived knowledge about thickening agents varied greatly, the majority selected response options that implied a level of understanding for effective interactions with basic care staff or nutrition professionals. Findings highlight a continued reliance on instant thickening products even though staff instruction about preparation remains inconsistent. Conclusions: Quality control concerns persist, including SLPs' limited familiarity and use of measurement tools for characterizing beverage consistency. Outcomes support standardized practices, including professional education activities for SLPs to learn about thickening products, the thickening process, and to educate/instruct in the preparation of thickened liquids for enhancing the nutritional care of individuals who consume them. [ABSTRACT FROM AUTHOR]

Purpose: The purposes of this study were to measure the perceptions of speech-language pathologists (SLPs) and researchers regarding the design of visual scene displays (VSDs) and to investigate the perceived difficulties of SLPs in regard to the acquisition and programming of VSDs. Method: We recruited 270 SLPs and nine researchers who focus on VSDs to complete an online survey. The SLP survey addressed both perception of VSD design and difficulties associated with implementing these images as communication supports in the clinical realm. The researcher group was surveyed solely regarding their opinions associated with VSD design. Results: SLPs and researchers both ranked high-context VSDs as more effective at supporting communication than low-context VSDs. In addition, both groups ranked VSDs with task-engaged people as more effective at supporting communication than VSDs with camera-engaged people or no people. SLPs reported difficulties with acquiring highquality VSDs from online sources as well as difficulties with maintenance and upkeep of VSDs. In addition, a large portion of SLPs reported challenges with representing complex concepts through VSDs. Conclusions: Results from this study provide evidence of general agreement between SLPs and researchers regarding perception of VSD design. SLPs continue to report challenges with the acquisition and programming of VSDs. Further research is needed to develop evidence-based guidelines to support clinical endeavors in these areas. [ABSTRACT FROM AUTHOR]

Purpose: Many speech-language pathologists (SLPs) experience challenging behaviors during service delivery and also report minimal training in effective behavior management strategies. The purpose of this tutorial is to present low-effort behavior management strategies that SLPs can adopt, adapt, and implement. Method: After providing an overall rationale for effective behavior management strategies, we present two evidencebased behavior management strategies aimed at improving positive behavior and engagement. We provide descriptions, steps, and applied examples for implementing visual activity schedules and behavior-specific praise. We include three implementation scenarios and resources for SLPs to access specifically tailored to speech-language pathology practice. Conclusions: Visual activity schedules and behavior-specific praise are two flexible behavior management strategies that can be collaboratively created by SLPs and educators and implemented during a variety of instructional arrangements during speech and language therapy. Implementing evidencebased behavior management strategies may improve students' engagement and achievement in speech and language-focused outcomes. [ABSTRACT FROM AUTHOR]

Purpose: The patient's perspective of their health is a core component of evidence-based practice (EBP) and personcentered care. Patient-reported outcomes (PROs), captured with PRO measures (PROMs), are the main way of formally soliciting and measuring the patient's perspective. Currently, however, PROs play a relatively small role in mainstream speech-language pathology practice. The purpose of this article is to raise important questions about how PROs could be applied to EBP in speech-language pathology for individuals with communication disorders and to propose preliminary approaches to address some of these questions. Method: Based on a narrative review of the literature, this article introduces relevant terminology and broadly describes PRO applications in other health care fields. The article also raises questions related to PRO-informed clinical practice in speech-language pathology. To address some of these questions, the article explores previous research to provide suggestions for clinical administration, interpretation, and future research. Conclusion: More routine measurement of subjective health constructs via PROMs--for example, constructs such as effort, participation, self-efficacy, and psychosocial functioning --may improve EBP. More routine use of PROMs could significantly expand the information that is available to clinicians about individual clients and add to the evidence base for the profession of speech-language pathology. However, careful consideration and more research are needed on how to capture and interpret PROs from individuals with cognitive and language disorders. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated reading teachers' (RTs) views of speech-language pathologists' (SLPs) abilities to provide services for clients who have written language disorders. Previous research has shown SLPs often do not provide such services due to time constraints, lack of training, and their perception that other school personnel are more qualified. However, little is known about RTs' views of SLPs' abilities to provide reading/writing intervention. Method: Three hundred twenty-three RTs responded to a survey designed to determine their perceptions and experiences of SLPs providing services to children with written language difficulties. Respondents were from all regions of the United States. Results: Approximately 80% of the respondents supported the idea of SLPs providing written language intervention services, with 69% recognizing that there was an evidence base for such intervention. However, many RTs registered some disagreement that SLPs had sufficient training to provide written language instruction and may lack knowledge of the curriculum. These results also identified factors that SLPs wishing to be involved in literacy instruction may need to address including administrative support, involvement in school-wide literacy learning decisions, and participation in professional development opportunities on literacy instruction. Conclusion: These results indicated that RTs may be supportive of SLPs addressing the written language needs of the students they serve. Although written language intervention is within SLPs' scope of practice, SLPs currently practicing in school settings may need to advocate for themselves to actively be involved in written language instruction. [ABSTRACT FROM AUTHOR]

Purpose: Considering the American Speech-Language- Hearing Association's (ASHA) global influence and continued emphasis on heightening multicultural receptivity, a major consideration for ASHA is to cultivate cultural sensitivity and competence in its largely female (95.30%), monolingual (93.46%), and White (92.10%) workforce. ASHA's 32-year transition from no formal multicultural education to mandatory multicultural education infusion provokes to enquire whether multicultural education in speech-language pathologists (SLPs) has modified SLPs' perceptions toward multicultural issues. In this article, we explored an aspect of such sensitivity. We want to know whether there exists a linear relationship between SLPs' age, as an index of their exposure to formal multicultural education, and SLPs' bias toward nonnative accent, as an index of their multicultural sensitivity. Method: Two hundred sixty-eight SLP ASHA members completed a web-based pilot survey testing whether SLPs made biased associations based on personality traits, sociocultural factors, professional attire, and physical appearance of persons with nonnative accent and whether the SLPs thought they had an accent. Logistic regression tested whether age predicts explicit biased associations for these five outcomes. Results: ASHA SLPs made biased associations with accent for all outcomes, but age only predicted the likelihood of explicit accent-based biases for physical appearance. The relationship was curvilinear, with 40- to 45-year-olds making the most biased associations and older SLPs making progressively fewer biased associations. Conclusion: Clearly, the specific psychosocial attributes associated with perception of nonnative accent need to be explored from a dynamical systems perspective to discover potential variables that might directly or indirectly influence accent perception and potential biases. [ABSTRACT FROM AUTHOR]