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This study explored how speech-language pathologists (SLPs) in Jordan perceived and implemented telepractice at the beginning of the COVID-19 pandemic, from April to June 2020. Eighty-five SLPs who provided telepractice and 57 SLPs, who did not, completed an online survey sharing their perceptions related to the delivery and barriers of telepractice. The results showed a significant increase of telepractice use in response to the pandemic. However, the SLPs identified several barriers to telepractice, including environmental distractions at the client's end, limited computer knowledge, technological issues, internet connectivity problems, and platform availability. There was general agreement among the SLPs regarding the need for professional training and governmental guidelines to regulate the use of telepractice. The study's findings demonstrate how SLPs in Jordan adapted to the sudden shift toward telepractice, and identify potential implementation obstacles, which could assist in establishing telepractice as a reliable model for speech-language therapy services in the future. [ABSTRACT FROM AUTHOR]

Children with developmental language disorders (DLDs) may experience barriers to communicative participation. Communicative participation is defined as 'participation in life situations in which knowledge, information, ideas or feelings are exchanged'. Barriers experienced in communicative participation cannot be explained by language competence alone and are thought to be influenced by contextual factors. A better understanding of these factors will contribute to tailored speech and language therapy services for children with DLD. We conducted a focus group study with 13 speech and language therapists' (SLTs) to explore their perspectives on contextual (environmental and personal) factors in early childhood that are associated with communicative participation in children with DLD. The personal factor of child well-being, and the environmental factors of familial support and SLT service provision were developed through thematic analysis. The potential mediating role of these factors on communicative participation implies that it is important to address contextual barriers and facilitators in speech and language therapy services. [ABSTRACT FROM AUTHOR]

Music has been shown to improve social interaction and attention to verbal stimuli in autism. We report a feasibility randomised controlled trial of an online intervention using music-assisted programmes, compared with best-practice treatment (Social Communication Intervention for Pre-schoolers–Intensive) for language learning in preschool autistic children with minimal verbal language. Minimisation randomisation ensured comparability of groups before intervention. Ninety-one people expressed interest in taking part; 27 met eligibility criteria and were randomised to receive either music-assisted programmes or Social Communication Intervention for Pre-schoolers–Intensive. Children and their parent received two 45-min sessions weekly, over 18 weeks, coached online by a speech and language therapist. A smartphone app was developed to support home-based practice between sessions. Over the study period, 20% of participants completed the intervention and assessments of outcome measures. At 3 months post-intervention follow-up, social responsiveness, understanding of words and phrases and number of words spoken and parent–child interaction improved more in the music-assisted programmes than the Social Communication Intervention for Pre-schoolers–Intensive group. The results demonstrate the feasibility of recruiting this population into a randomised controlled trial and the music-assisted programmes had high perceived acceptability highlighted by parent interviews. A full clinical trial to establish music-assisted programmes' effectiveness in improving early vocabulary learning in autistic children is warranted. Research has shown that autistic individuals often have unusually good musical skills and that combining words and music helps autistic individuals to focus on spoken words. This study tests the idea that music will help with early language learning of preschool autistic children. The results show that when caregivers sing words to autistic children, the children pay more attention to the caregiver than when the words are spoken and that they learn word combinations more easily. [ABSTRACT FROM AUTHOR]

Auditory feedback plays an important role in the long-term updating and maintenance of speech motor control; thus, the current study explored the unresolved question of how sensorimotor adaptation is predicted by language-specific and domain-general factors in first-language (L1) and second-language (L2) production. Eighteen English-L1 speakers and 22 English-L2 speakers performed the same sensorimotor adaptation experiments and tasks, which measured language-specific and domain-general abilities. The experiment manipulated the language groups (English-L1 and English-L2) and experimental conditions (baseline, early adaptation, late adaptation, and end). Linear mixed-effects model analyses indicated that auditory acuity was significantly associated with sensorimotor adaptation in L1 and L2 speakers. Analysis of vocal responses showed that L1 speakers exhibited significant sensorimotor adaptation under the early adaptation, late adaptation, and end conditions, whereas L2 speakers exhibited significant sensorimotor adaptation only under the late adaptation condition. Furthermore, the domain-general factors of working memory and executive control were not associated with adaptation/aftereffects in either L1 or L2 production, except for the role of working memory in aftereffects in L2 production. Overall, the study empirically supported the hypothesis that sensorimotor adaptation is predicted by language-specific factors such as auditory acuity and language experience, whereas general cognitive abilities do not play a major role in this process. [ABSTRACT FROM AUTHOR]

Rehabilitation services are critical to improve health outcomes, particularly at community level within primary healthcare settings. As groups with an interest in the health system, rehabilitation service users' and caregivers' involvement in various aspects of health system strengthening is important for healthcare planning and evaluation. This study aimed to explore rehabilitation service users' perceptions of the rehabilitation services and their effect on their functioning in the Johannesburg Metropolitan District. A qualitative study was conducted using purposive sampling of participants attending rehabilitation at nine provincially funded clinics. Semi-structured interviews were conducted, and data were analysed using reflexive thematic analysis. The findings revealed the theme of happy with rehabilitation services and five associated categories, namely (1) service provider actions, (2) service organisation, (3) service user actions, (4) service access, and (5) service outcomes. The participants expressed overall satisfaction with their experiences of rehabilitation services, highlighting the importance of effective communication, patient-centred care, strong therapeutic relationships, and active patient engagement to achieve positive outcomes. This study provides the evidence for maintaining and extending rehabilitation at the PHC level in support of the health policy changes proposed for South Africa. [ABSTRACT FROM AUTHOR]

Background and aims: Current evidence shows that children with developmental language disorder (DLD) benefit from spaced retrieval during word learning activities. Word recall is quite good relative to recall with alternative word learning procedures. However, recall on an absolute basis can be improved further; many studies report that fewer than two-thirds of the words are learned, even with the assistance of spaced retrieval during the learning activities. In this article we identify details of spaced retrieval that are less well understood in an effort to promote more effective learning through retrieval practice. Main contribution: We discuss the importance of factors such as: (a) integrating immediate retrieval with spaced retrieval trials; (b) determining whether gradual increases in spacing have more than short-term benefits relative to equal spacing; (c) discovering the number of successful retrievals sufficient to ensure later recall; (d) using spaced retrieval to avoid erosion of phonetic details on later recall tests; and (e) whether the well-documented difficulties with learning word forms might be tied to a particular subgroup of children with DLD. We also speculate on some of the possible reasons why spaced retrieval is beneficial in the first place. Conclusions: Although many children with DLD make gains in word learning through procedures that incorporate spaced retrieval, there are numerous details involved in the process that can alter its success. Until we have a better understanding of the boundaries of spaced retrieval's effectiveness, we will not be taking full advantage of this promising addition to word learning procedures. Implications: Spaced retrieval activities can be an important addition to the resources that clinicians and educators have available to assist children in their word learning. With a deeper understanding of the issues discussed here, we should be able to put spaced retrieval to even greater use. [ABSTRACT FROM AUTHOR]

School-age English learners (ELs) are faced with the challenging task of acquiring a foreign language while simultaneously reading academically demanding literature. Therefore, the current research aimed to examine the relation between the rate of grammatical tense marking errors made by ELs and their performance on measures of reading comprehension (RC). The sample for the current study included 5th-grade students who were categorized as ELs who were receiving English support services (N = 103). Samples were collected using i-Ready and writing samples. The samples were used to examine ELs' RC in relation to tense marking errors in their written responses on the district writing assessment at the end of the school year. The results from the study revealed that there was a moderate negative correlation (r = −.431, p <.010) between verb tense errors and reading comprehension. Students with high rates of verb tense errors received lower RC scores. [ABSTRACT FROM AUTHOR]

The publicly funded early intervention program for preschoolers with autism spectrum disorder (ASD) in Nova Scotia, Canada, uses the pivotal response treatment (PRT) model. Parents are coached in use of PRT strategies during their children's first week of treatment. We explored whether parents of older preschoolers with limited verbal ability learned to implement PRT strategies with fidelity after brief coaching and whether PRT strategy use was associated with gains in children's communication skills. We coded precoaching and postcoaching parent–child play episodes of 39 children (4.4–5.5 years) with limited verbal skills for parents' PRT fidelity and children's correct responding to language opportunities and frequency of initiations. Parents' use of PRT strategies significantly improved, as did children's responsiveness to parent-provided language opportunities. This study provides evidence for the utility of brief parent coaching in PRT for older preschoolers with ASD whose verbal skills are limited. [ABSTRACT FROM AUTHOR]

Multilingual children living in areas with low socioeconomic status (SES) are at an increased risk of having speech, language and communication needs (SLCN). Many multilingual children with SLCN in Sweden have insufficient basic vocabulary knowledge in the majority language, preventing them from achieving the school's learning goals. However, there is a lack of studies of interventions that could improve vocabulary development in this group, and that can be delivered in an everyday educational setting. This pilot study evaluates the effect of a school-based vocabulary group intervention, which combines elements from shared book reading and the Lexicon Pirate method, on vocabulary skills. A non-randomised pretest–posttest control group design was used. Eighteen six- to seven-year-old multilingual children attending preschool class in low SES areas either received intervention (n = 9) or were included in a control group (n = 9). The intervention group participated in 12 intervention sessions over six weeks. Word knowledge, semantic fluency, and comprehension of semantic relations were assessed pre- and post-intervention. Results revealed that children in the intervention group demonstrated significant gains in knowledge of both trained and untrained words, compared to the control group. No effects were found on semantic fluency or comprehension of semantic relations. [ABSTRACT FROM AUTHOR]

Surgical intervention can contribute to the development of velopharyngeal insufficiency (VPI) leading to hypernasality and regurgitation. In this case, a patient with a history of bilateral buccal flaps used for her primary CP repair presented to clinic with hypernasality and VPI as assessed by speech exam and imaging. She underwent repeat bilateral buccal flap palatal lengthening with division of the pedicles 3 months later. Three months after her division, her hypernasality score improved from moderate to mild and her posterior gap decreased. This study concluded buccal flaps can be used a second time for patients needing palatal revisions for VPI. [ABSTRACT FROM AUTHOR]

Background and aims: This study was conducted in a clinical setting with the aim of replicating previously used procedures for teaching receptive vocabulary. Researchers increased the number of vocabulary words and maintained use of match-to-sample (MtS), prompting, and reinforcement procedures. Researchers were also interested in the efficacy of the intervention from caregivers' perspectives. Methods: Using a concurrent multiple baseline design, two autistic preschoolers with receptive language impairment were taught to identify 30 common objects. MtS, prompting, and reinforcement procedures were individualized to support each child. Maintenance checks and generalization probes were completed after a predetermined number of intervention sessions (i.e. three or four clinic sessions). A social validity questionnaire was completed by parents following the final maintenance check. Results: Receptive object identification improved significantly for both participants. Despite exposure to vocabulary targets for only three or four sessions, they generalized the vocabulary targets to non-identical pictures and maintained words at maintenance checks. Participants were most successful when researchers individualized prompting and reinforcement. Conclusion: MtS, prompting, and reinforcement were effective procedures for improving object identification, even with a limited number of intervention sessions. To support varying learner profiles, modifying prompting and reinforcement procedures was necessary. Caregivers of both participants reported positive improvements in areas such as communication, attention, and behaviors. Implications: This replicated study provides support for MtS, prompting, and reinforcement as means of teaching receptive vocabulary to autistic preschoolers in a clinical setting. The materials used were simple and cost-effective. Overall, this study outlines and supports a flexible and effective evidence-based practice to teach receptive language to autistic children. [ABSTRACT FROM AUTHOR]

Background and Aim: Recently, there has been a lot of interest surrounding the term gestalt language processor (GLP) which is associated with Natural Language Acquisition (NLA): a protocol intended to support the language development of autistic people. In NLA, delayed echolalia is presumed raw source material that GLPs use to acquire language in a stage-like progression from delayed echolalia to spontaneous speech. The aim of this article is to evaluate NLA in light of relevant literatures to allow scrutiny of NLA claims. Main contributions: First, we review the notion of gestalt language and situate it in the broader literature on language styles to update understanding of its significance. We then review the links from gestalt language processing to autism and identify definitional and conceptual problems and clarify the construct 'episodic memory'. We discuss the 'raw material view of delayed echolalia' and identify theoretical and empirical shortcomings. Finally, we review Blanc's language stages and their accompanying assessment and language support recommendations and challenge their validity. Conclusions & Implications: The term 'gestalt language processor' is definitionally and conceptually troubled, the assertion that autistic people are GLPs is misleading and unhelpful, and evidence is lacking that GLP represents a legitimate clinical entity. The theoretical basis of NLA lacks empirical support. NLA stages are implausible and their accompanying assessment and support recommendations lack justification. We recommend the use of alternate, individualized, theoretically-sound, evidence-based, neurodiversity-affirming supports that are sensitive and responsive to the heterogeneity that defines autism. [ABSTRACT FROM AUTHOR]

Young refugee populations continue to grow. This scoping review aims to identify and summarize studies of programs that provide linguistically responsive practices for children who are refugees. Secondary aims of this review are: (a) to identify the gaps in the literature, and (b) to suggest future research and policy directions. By studying key features of linguistically responsive practices for children who are refugees, we can better understand the important components of a high-quality inclusive and equitable environment for all children, including those with minority language backgrounds. We conducted an electronic database search and identified 14 studies. Studies varied in location, country of origin, and language support. The findings from this review revealed a critical need to develop, implement, and study linguistically responsive programs for children who are refugees in host countries. [ABSTRACT FROM AUTHOR]

Providing high-quality services to students with disabilities in rural settings can be challenging, as rural schools often lack resources both in and out of the classroom. One potential option to provide high-quality mathematics instruction to students with disabilities in rural areas is using virtual manipulatives and online instruction. In this study, a single-case research design was used to examine the progress of three high school students with intellectual and developmental disabilities (IDDs) as they used a virtual money manipulative within an online learning environment to solve making change problems. The researchers found a functional relation between the intervention package (i.e., a virtual money manipulative, modeling, system of least prompts) and the dependent variable of accuracy in solving making change problems across three students. In addition, all three students demonstrated an increase in independence during each session and maintained their accuracy and independence after the intervention concluded. [ABSTRACT FROM AUTHOR]

The study reported herein sought to explore the effect of self-disclosure about stuttering on listener perceptions of persons who stutter (PWS). Sixty young adults who do not stutter were divided into three groups. Each group was assigned to one of three conditions: no disclosure (ND), apologetic self-disclosure (ApD), and assertive self-disclosure (AsD), followed by a narrative by a PWS presented auditorily. Participants then rated the PWS on a semantic differential scale. Results revealed no significant difference between listener ratings for ApD and ND conditions. The PWS in the AsD condition was perceived as "less sociable" than the PWS in the ND condition. The PWS disclosing assertively appeared to be rated more positively by female listeners. Being well acquainted with a PWS appeared to result in more positive perceptions indicating a need to educate the general public about stuttering. [ABSTRACT FROM AUTHOR]

Objectives: The G8 is a well-validated screening test for older cancer patients. The current study was undertaken to determine whether the G8 is predictive of short-term post-operative outcomes after head and neck cancer (HNC) surgery. Methods: Consecutive patients aged 65 years or more and referred for a preoperative assessment by a speech-language pathologist were consecutively screened by clinicians at 2 academic medical centers using the G8. The G8 was used to screen for vulnerability prior to surgery. Patients were deemed vulnerable if they had a total G8 score ≤14 according to published guidelines. Data were also collected on demographic characteristics, tumor staging, post-operative course, and tracheostomy and feeding tube (FT) status. Results: Ninety patients were consecutively screened during the study period. Using the G8, 64% of the patients were deemed vulnerable. Vulnerable patients differed significantly from non-vulnerable patients with regard to age, health, tumor stage, and baseline dysphagia, and underwent more extensive surgery. Postoperatively, vulnerable patients had a significantly longer hospital length of stay (LOS; 10.17 vs 5.50 days, respectively, P <.001), were less likely to discharge home (76% vs 94%, P =.044), and were more likely to be FT dependent for over a month (54% vs 21%, P =.006) compared to non-vulnerable patients. In regression models, controlling for T-stage and surgical variables, the G8 independently predicted 2 post-operative outcomes of interest, namely LOS and FT dependency. Conclusions: The G8 may be a useful screening tool for identifying older adults at risk of a protracted postoperative medical course after HNC surgery. Future research should aim to identify the optimal screening protocol and how this information can be incorporated into clinical pathways to enhance the post-operative outcomes of older HNC patients. [ABSTRACT FROM AUTHOR]

Tourette syndrome is characterized by at least two motor tics and one vocal tic, which persist for over a year. Infrequently, tics can manifest as blocking tics in speech when they prevent a person from starting to speak or interrupt their speech flow. Vocal blocking tics (VBTs) resemble stuttering, and they can be difficult to differentiate from each other. A previous report described two patients with severe VBTs who did not benefit from stuttering-therapy-based speech therapy and were treated effectively with cannabis-based medicine. Here, we present the cases of two patients, seven- and nine-year-old boys, who benefited from speech therapy in which stuttering therapy techniques were used. Detailed descriptions of the interventions are included. Further research is needed to test the effectiveness of speech therapy in treating VBTs in a larger group of children with Tourette syndrome. [ABSTRACT FROM AUTHOR]

While studies to map the priorities of the autistic community have been undertaken in some high-income countries, there has been little or no such systematic assessment in the global south. India alone is home to an estimated >5 million autistic individuals. To address this gap in the literature, this study conducted a survey of the Indian autism community on their priorities for three areas: skills training, intervention and research. Individuals with a clinical diagnosis of autism spectrum disorders and parents/guardians of autistic individuals were invited to take part in the study. Data from 280 respondents were collected online and followed up with interviews on a subset (n = 40) chosen through stratified random selection. Results highlighted a unanimous prioritisation for self-help skills as the most important area in skills training, as it was considered the foundation for acquiring all other skills. Speech and language therapy was identified as the most important intervention for autistic individuals. Within research, identifying the most effective ways for the community to support autistic people was given the topmost priority. Researchers, clinicians and policymakers may use these insights to develop services and shape future research that is more in accord with the community's needs. It is vital to directly engage with the autism community in order to develop better services and drive the research agenda. While some studies in high-income countries have mapped the priorities of the autism community, there is a severe dearth of such efforts in the global south. Five million autistic individuals are estimated to live in India alone, and there has been little effort to map their priorities. Moreover, studies in high-income countries focused largely on research priorities, and not so much on skills training and interventions. Keeping these needs in mind, we conducted an online survey followed by an in-depth conversation with parents of autistic children and autistic adults drawn from across India. We found that the respondents reported self-help skills to be the most important for training, as they considered it fundamental for every other aspect of life. Speech and language therapy was considered to be the highest intervention priority for this group, highlighting the importance of social communication. Mental health counselling was also considered to be a high priority, but several parents identified it as being more relevant for themselves rather than for their children. Within research, the topmost priority was to understand ways in which the community can better support autistic people. We hope that these findings will help researchers, policymakers and service providers to be able to make well-informed decisions, develop relevant services and shape future research. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study is to show the non-inferiority of the telemedicine therapy versus face-to-face using the exercise therapy of oropharyngeal muscles in 183 patients treated consecutively from 2010 to 2020. Method: We conducted a retrospective study comparing two dysphagia treatment groups: online versus face-to-face. Patients were distributed in a non-random way but according to patient's preferences. All patients followed the same pathway and were evaluated at the beginning and at the end of the study using the dysphagia outcome and severity scale and the functional oral intake scale. A non-inferiority analysis approximation was done with delta = 1 in both variables. Results: Within a total of 183 patients, 114 (62.3%) used the online treatment and 69 (37.7%) the face-to-face one. The main cause of dysphagia was neurological in the total sample (60.7%) and within both groups. When we evaluate the clinical response, we find that both groups improved regardless of the type of therapy. The confidence interval of the difference between the beginning and the end of treatment did not reach the inferior limit of the delta defined, therefore supporting the no inferiority of online versus presential. Discussion: This study shows the no inferiority of the online therapy versus the face-to-face one for the oropharyngeal training of the swallow muscles. [ABSTRACT FROM AUTHOR]

This scoping review examined the existing research to identify culturally responsive and Indigenous language strategies. A five-stage scoping review methodology was applied to a multiple database search, and a web-based literature review software program was used to organize and review sources, resulting in a total of 33 sources. Data were charted from these sources and 38 culturally responsive strategies and 23 Indigenous language strategies were identified. These strategies, which include the highest strength of strategy codes based on source design qualities, are presented in a preliminary evidence map. There remains a scarcity of culturally responsive and Indigenous language intervention research with Indigenous children. Most of the strategies identified through this scoping review lacked strength to recommend their use universally, but they still may be useful and critically important in meeting the needs of Indigenous children and their families. A discussion on strategies, the Indigenous Connectedness Framework, and an abundance model is provided. [ABSTRACT FROM AUTHOR]

This study explored the demonstration of culturally responsive service provision when planning intervention by speech-language pathologists (SLPs). A fifteen-item survey revealed (a) SLPs consider culture when choosing therapeutic materials, and (b) family structure was the cultural factor selected by the most SLPs, followed closely by race and/or ethnicity. Religion was the least commonly selected cultural factor. Knowledge of multiple factors of culture should be considered to provide culturally competent intervention. [ABSTRACT FROM AUTHOR]

Echolalia is a typical feature of children with epilepsy and autism, but whether it is pathological is still controversial. This article aims to explore the contentious issue of echolalia based on data from three selected Chinese children with epilepsy and autism. Through discourse analysis, we explored two types of echolalia: immediate echolalia and delayed echolalia. It was found that the two types of echolalia were used to achieve interactional function, interpersonal function, and experiential function. Our research also found that the echolalia phenomenon reflected the participants' pragmatic awareness when dealing with new information. This article will contribute to understanding echolalia in children with epilepsy and autism and provide intervention methods for children with language impairment. [ABSTRACT FROM AUTHOR]

The purpose of this large-scale descriptive study was to investigate the impact of an implementation model designed to provide U.S. classroom teachers with the knowledge, skills, and resources required to provide aided augmentative and alternative communication (AAC) instruction to their students with extensive support needs and complex communication needs. We followed 49 students with extensive support needs and limited symbolic communication across 2 years in the classrooms of 53 teachers who engaged in ongoing coaching and professional development. At pretest, the students demonstrated an average of 15 of the 80 (19%) expressive skills on the Communication Matrix. Multilevel longitudinal modeling was used to analyze changes in scores over time. The findings suggest there was a statistically significant relationship between time and Communication Matrix scores, with the ends of each academic year associated with statistically significant growth at rates of 3.01% and 12.38%, respectively. Implications for practice and future directions are discussed. [ABSTRACT FROM AUTHOR]

This case report explores clinical treatment efficacy in a Cantonese-speaking child with 22q11.2 Deletion Syndrome where diagnosis and management of velopharyngeal dysfunction can be considered late. All treatment sessions were undertaken via telepractice during the peak of the COVID-19 pandemic in Hong Kong. A hybrid of specialized cleft palate speech treatment techniques and traditional treatment approaches in Speech Sound Disorders were utilized. Treatment intensity components including dose, dose form, session duration, and total intervention duration were documented. [ABSTRACT FROM AUTHOR]

Covert contrast is the statistically reliable distinction between target language phonemes produced in the process of language acquisition that is nevertheless not perceived by a native speaker of that language. This paper examines the acquisition of contrasts in four Najdi Arabic fricatives, /s/, /ʃ/, /θ/, and /ð/, and seeks to identify the most common substitutions in producing these sounds. Words were elicited from 25 preschool children (aged 3–5 years). The target words contained the studied fricative followed by either long /a:/ or short /a/ in the initial position. Praat software was used for acoustic analysis to extract the four acoustic cues: center of gravity, fricative noise duration, F1, and F2. Participants performed a word repetition task and a picture elicitation task. The results showed six cases of covert contrast, seven cases of no contrast, and 87 cases of accurate production (overt contrast). The results also revealed stopping, gliding, and affrication as substitutions in the manner of articulation, while replacement in place of articulation occurred in backing but most commonly in fronting (24 cases). The present study sought to determine implications for children's linguistic performance, and, consequently, for language education and for planning treatment for children with speech disorders. [ABSTRACT FROM AUTHOR]

In order to meet the communication needs of individuals who use Augmentative and Alternative Communication (AAC) devices, communication partners are often responsible for the programming of the AAC devices. However, the prolonged learning time and operational demands of AAC devices are often barriers to an efficient use of time during a therapy session. We developed a prototype app for iPad, called Speech-to-Symbol that decreases the programming time by finding pictures stored in the app using speech-to-text technology. We compared our solution to the TalkTablet app during AAC sessions with children with different communication disabilities. The aims of this study were 1) to compare the time to program both apps, 2) to identify the type of vocabulary used, and 3) to assess the usability of the two apps. Results showed that the reduced operational demands of our Speech-to-Symbols app allow communication partners to expose children to a larger and more diverse vocabulary. In addition, the communication partners gave our Speech-to-Symbols app a higher usability rating. Implications for clinical and educational settings and directions for future research are also discussed. [ABSTRACT FROM AUTHOR]

Many children with developmental language disorder (DLD) have a vocabulary deficit. One of the most effective interventions for increasing children's lexicon size is the semantic and phonological approach, an approach that has been used mainly with adolescents. The goals of our study are (1) to test whether the semantic-phonological approach coupled with rich vocabulary instruction is effective with younger children with DLD on words learned during the training and (2) to check whether the gains can be maintained over the long term. A group of eight French-speaking children (aged 6 to 10), with a diagnosis of DLD, underwent a phonological-semantic group intervention over 5 months. Four lists (vegetables, animals, school materials, and sports) of words were trained, each category involving 3-hour sessions. Five-word lists (L1, L2, L3, L4, and L5) corresponded to the four trained categories and one served as control. When L1 words were trained, L2 served as the control list; then when L2 words were trained, L3 was the control list, and so on. The group results indicated significant improvement on the four trained lists once intervention was introduced, and no improvement on the control lists. All effects were maintained over the long term at the delayed posttest. Individual outcomes were dependent on children's cognitive and language profiles. Vocabulary training thus allowed young French-speaking children with DLD to enrich their vocabulary on specific measures. The implications of the results are discussed at the group and individual level. [ABSTRACT FROM AUTHOR]

Introduction: The effectiveness of inpatient rehabilitation services has been well supported. However, patients receiving inpatient rehabilitation may be physically inactive outside of therapy. The primary objectives were to determine differences in activity levels between rehabilitation time and non-rehabilitation time and rehabilitation day and non-rehabilitation day during inpatient rehabilitation stay. The secondary objective was to determine differences among rehabilitation services. Methods: In all, 50 participants wore an ActiGraph GT9X Link on their non-dominant wrist during their inpatient rehabilitation stay. Results: We found significant differences in total activity counts between rehabilitation time and non-rehabilitation time (z = 6.15, p < 0.001) and between rehabilitation day and non-rehabilitation day (z = 5.82, p < 0.001). We found significant differences in total activity counts between occupational therapy and physical therapy (z = 5.71, p < 0.001), occupational therapy and speech-language pathology (z = 3.41, p < 0.001), and physical therapy and speech-language pathology (z = 3.07, p = 0.002). The degrees of all differences were large. Conclusion: To increase the activity levels during non-rehabilitation times and days, patients receiving inpatient rehabilitation may benefit from strategies which increase activity levels such as an individualized program that can be safely and independently performed outside of rehabilitation sessions. [ABSTRACT FROM AUTHOR]

Objective: To study the post-operative evolution of voice quality of patients treated by transoral CO2 laser microsurgery (TLM) according to the age. Methods: Patients treated by type I to VI TLM and post-operative speech therapy were prospectively recruited from our hospital. The voice quality was assessed pre-, 1-, 3- 6- and 12-month posttreatment with voice handicap index (VHI), dysphonia, roughness, breathiness, asthenia, strain (GRBAS), maximal phonation time (MPT), F0, F0 standard deviation (STD), percent jitter, percent shimmer, noise-to-harmonic ratio (NHR), vocal fold vibration assessment and speech fluency. Evolution of voice outcomes was analyzed considering age of patients (< 60 vs. ≥ 60 years). Results: Seventy-five patients completed the evaluations. Thirty-four and forty-one patients were < 60 or ≥ 60 yo, respectively. Subjective and objective voice parameters (VHI, G, R, B), jitter and fluency significantly improved from 1- to 6-month post-TLM in < 60 yo individuals. The voice parameters improved 12-month post-TLM in the ≥ 60 yo group at the exception of VHI that improved 3-month post-TLM. There were positive associations between age and 12-month NHR, G and A parameters. Conclusion: The post-operative evolution of voice quality parameters may vary between patients according to the age. Preoperative VHI is predictive of 12-month subjective and objective voice outcomes. [ABSTRACT FROM AUTHOR]

Primary progressive aphasia (PPA) is a neurodegenerative disease characterized by the insidious and progressive loss of speech and language skills. However, there is no standardized intervention method applied in patients with PPA. It was conducted a virtual survey of SLTs across Turkey, to collect information about the assessment, intervention and management of patients with PPA. A total of 285 SLTs participated the survey; 76.8% (n = 219) of the respondents were female, 58.9% (n = 168) were 1 to 2 years post graduation, 62.8% (n = 179) of them were master's degree, and 46% (n = 131) were working in a rehabilitation center. All 285 participants included in the study stated that they did not create a therapy process for their clients with PPA and they performed the therapy processes applied in the classical aphasia treatment. Two hundred sixtyeight participants stated that they had more than six sessions with their clients, and 280 respondents. It is very important for all participants to plan functional interventions that require joint participation with the patient and their family/caregiver or friends, which will support communication and language and communication-oriented intervention. However, there is a need to develop specific evidence-based care pathways for people with PPA so that more efficient interventions can be made. Raising awareness among SLTs and other clinical service providers that rehabilitation is effective can increase the accessibility of interventions for individuals with PPA and lead to a more robust support system for individuals affected by PPA. [ABSTRACT FROM AUTHOR]

Teaching vocabularies to young children is critical as vocabulary is related to long-term language, literacy, and academic skills. The current study used a multiple probe design to examine the effects of enhanced milieu teaching with book reading on the use of word approximations in four 2- to 4-year-old females with language delay. The first author implemented the intervention in families' homes for 3 to 5 days a week over 3 months. Through visual analysis and the calculation of effect sizes, the results showed that there was a functional relation between the intervention and the number and frequency of targeted word approximations. After six to 25 intervention sessions, participants used all five targeted word approximations, and the improvements were maintained up to 15 weeks. In addition, the total frequency of targeted word approximations used after prompts and the proportions of prompts used to elicit the targeted word approximations were measured and analyzed. Parents reported high social validity of the intervention via an anonymous questionnaire. Implications for practice and research of family-centered early intervention are discussed. [ABSTRACT FROM AUTHOR]

This study evaluated acquisition, preference, and generalization of two forms of augmentative and alternative communication (AAC) during functional communication training (FCT) with two students with autism spectrum disorder (ASD). Acquisition of FCT responses, using a picture-based communication system and speech-generating device (SGD; Apple iPod Touch with the Proloquo2Go), was compared. Following acquisition, preference of response mode was evaluated for each participant. Both AAC systems were made available simultaneously during FCT sessions, and data were collected on participants' initiation of functional communication (FC) on each modality. Findings indicated FC responses with the picture-based communication system and the SGD were acquired with similar rates by both participants. Furthermore, both participants demonstrated a consistent preference for the SGD as compared with the picture-based communication system. Both participants generalized the preferred FCT mode (i.e., SGD) to their classroom setting with their classroom teacher. Results indicate it is important to assess both acquisition efficiency and preference when selecting AAC systems for individuals with autism. [ABSTRACT FROM AUTHOR]

This study examines the displayed communicative competence and agency of a non-speaking student at a compulsory school for children with severe learning disabilities. The use of two different speech-generating devices (a single-message versus a multi-message speech-generating device) and the assignment of participation role (having the role of 'student' or 'teacher') were compared in two morning meetings. The two interactional sequences 'question-answers' and 'repair actions' were chosen because they provide participants with opportunities to display communicative competence and agency. The analysis showed that the displayed communicative competence and agency of the non-speaking student differed in relation to the kind of speech-generating device and the associated participatory role. Furthermore, the displayed communicative competence and agency was a product of the close collaboration between the student and the assistant and teachers who scaffolded the process. The study shows that teachers and assistants can influence the communicative competence and agency of non-speaking students. [ABSTRACT FROM AUTHOR]

Since its inception, special education has historically been an underfunded federal mandate leaving states and school districts unable to offer more than a basic level of support for individuals with disabilities. The amount and frequency of time allotted for special services including Speech Therapy, Occupational Therapy, and Physical Therapy is not sufficient for making significant and lasting progress, and many parents have expressed dissatisfaction with the current service delivery model. In this paper, we explore the issue of accessibility and how technology may play a role in leveling the playing field for students who, prior to this COVID-19 pandemic, were receiving inadequate levels of intervention to make progress on goals outlined within their Individualized Education Program. We explore one teacher's experience implementing a new application in her classroom aimed at increasing writing accuracy, while addressing the need for platforms that are engaging and promote parent participation. [ABSTRACT FROM AUTHOR]

In many autistic children, speech onset is delayed and expressive language emerges after 3 years of age. We qualitatively and quantitatively describe oral productions of autistic preschoolers, including many non- or minimally speaking, recorded during interactions with a caregiver and with an experimenter. Data clustering on manually coded oral production samples indicates five validated linguistic profiles of oral production in this diverse and inclusive sample (n = 59) of 3- to 5-year-old autistic children with highly variable expressive language abilities. These profiles are then compared on a series of demographic (age, socioeconomic status) and psychometric (autism severity, nonverbal and verbal IQ) measures, as well as on additional measures of language (expressive vocabulary, phonetic inventories). Two clusters are composed of speaking autistic children, while the three others comprise non- or minimally speaking children with qualitatively different patterns of vocal productions. The five-profile division suggests that traditional binary division of speaking vs nonspeaking children does not do justice to the complexity of early expressive language in autism. For most autistic children, spoken language emergence and development happen after the age of 3. Once they start developing and using spoken language, some eventually manage to reach typical levels of language abilities, while others remain minimally speaking into adulthood. It is therefore difficult to consider young autistic preschoolers as a homogeneous group in terms of spoken language levels. In our study, we breakdown a representative and inclusive group of children on the spectrum aged from 3 to 5 into five subgroups that correspond to different linguistic profiles. To do so, we qualitatively described children's (pre)verbal productions elicited during interactions with a parent and with an experimenter. We then used a type of statistical analysis called cluster analysis to group together the children that had a similar expressive (pre)linguistic behavior. Using this analysis, we were able to delineate five linguistic profiles with qualitatively different patterns of vocal production. Two of these profiles are composed of speaking children; the three others are composed of non- or minimally speaking children. Our findings show that traditional binary division of speaking versus nonspeaking autistic children is not precise enough to describe the heterogeneity of early spoken language in young autistic children. They also support the use of qualitative descriptions of vocal productions and speech to accurately document children's level of language, which could, in turn, help design very finely tailored language intervention specific to each child. [ABSTRACT FROM AUTHOR]

Background: There is growing evidence to support the use of ultrasound as a tool for the assessment and treatment of speech, voice and swallowing disorders across the Speech and Language Therapy profession. Research has shown that development of training competencies, engagement with employers and the professional body are vital to progressing ultrasound into practice. Methods: We present a framework to support translation of ultrasound into Speech and Language Therapy. The framework comprises three elements: (1) scope of practice, (2) education and competency and (3) governance. These elements align to provide a foundation for sustainable and high-quality ultrasound application across the profession. Results: Scope of practice includes the tissues to be imaged, the clinical and sonographic differentials and subsequent clinical decision-making. Defining this provides transformational clarity to Speech and Language Therapists, other imaging professionals and those designing care pathways. Education and competency are explicitly aligned with the scope of practice and include requisite training content and mechanisms for supervision/support from an appropriately trained individual in this area. Governance elements include legal, professional and insurance considerations. Quality assurance recommendations include data protection, storage of images, testing of ultrasound devices as well as continuous professional development and access to a second opinion. Conclusion: The framework provides an adaptable model for supporting expansion of ultrasound across a range of Speech and Language Therapy specialities. By taking an integrated approach, this multifaceted solution provides the foundation for those with speech, voice and swallowing disorders to benefit from advances in imaging-informed healthcare. [ABSTRACT FROM AUTHOR]

Background and Objectives : A national survey of cleft teams was undertaken to evaluate the current standard of care for patients with cleft lip and palate (CLP) in India as a part of Cleft Care India study. Design : This was a cross-sectional questionnaire-based study. Method : Cleft teams across India attending the 19th Annual Conference of the Indian Society of Cleft Lip and Palate were invited to complete the questionnaire. The questionnaire consisted of 18 questions that included demographics, institutional details, patient protocols, surgical technique, rehabilitation facilities, and accessibility. The data are descriptively reported. Results : A total of 112 centers completed the survey. Nongovernment organizations funded 87% of the cleft centers and 8% did not receive any funding. Only 39% of the centers had centralized cleft services providing multidisciplinary care. Speech therapy was provided either onsite or through referral at 90% of the centers, whereas audiology was provided only at 4% of centers. Feeding advice was routinely provided in 52% of centers. Millard technique was the most preferred technique for unilateral cleft lip repair (66%). The 2-flap technique (37%) and pharyngeal flap (48%) were the most common surgeries for cleft palate and pharyngoplasty, respectively. Although 54% of centers reported their patients to be interested in comprehensive care, 43% reported that their patients only wanted surgical correction. Conclusions : There is wide diversity in access to cleft care and clinical practices across centers in India. Further work is needed to evaluate the quality of care by assessing outcomes of centers treating patients with CLP. [ABSTRACT FROM AUTHOR]

Objective : A consortium of global cleft professionals, predominantly from low- and middle-income countries, identified adaptations to cleft care protocols during and after COVID-19 as a priority learning area of need. Design : A multidisciplinary international working group met on a videoconferencing platform in a multi-staged process to make consensus recommendations for adaptations to cleft protocols within resource-constrained settings. Feedback was sought from a roundtable discussion forum and global organizations involved in comprehensive cleft care. Results : Foundational principles were agreed to enable recommendations to be globally relevant and two areas of focus within the specified topic were identified. First the safety aspects of cleft surgery protocols were scrutinized and COVID-19 adaptations, specifically in the pre- and perioperative periods, were highlighted. Second, surgical procedures and cleft care services were prioritized according to their relationship to functional outcomes and time-sensitivity. The surgical procedures assigned the highest priority were emergent interventions for breathing and nutritional requirements and primary palatoplasty. The cleft care services assigned the highest priority were new-born assessments, pediatric support for children with syndromes, management of acute dental or auditory infections and speech pathology intervention. Conclusions : A collaborative, interdisciplinary and international working group delivered consensus recommendations to assist with the provision of cleft care in low- and middle-income countries. At a time of global cleft care delays due to COVID-19, a united approach amongst global cleft care providers will be advantageous to advocate for children born with cleft lip and palate in resource-constrained settings. [ABSTRACT FROM AUTHOR]

Introduction: Telerehabilitation is a tool for patients who, for different reasons, cannot participate in person with their physical presence. We aimed to identify the factors associated with satisfaction with telerehabilitation in families with children with neurodevelopmental disorders through a program that included physiotherapy, occupational therapy, and speech therapy. Methods: The program was developed during the COVID-19 lockdown period. Outcome measures: Child's age, the school stage to which they belonged, the person of reference in their daily care at home. The resources provided to the families, as well as the frequency of activities and difficulties detected, were evaluated through a survey. Findings: One hundred thirteen families responded to the survey. The general assessment resources were classified as very good. The average frequency of carrying out the activities was two times a week, with an average of 30 minutes per session. The ability to understand the information in the manual was not affected by the academic status of the caregivers (p = 0.286). Conclusions: This is the first study to quantify the multidisciplinary approach to children with neurodevelopmental disorders using telerehabilitation. The results show high levels of participation and satisfaction. The resources could be shared for their applicability in other countries whose families have similar needs conditioned by COVID-19. [ABSTRACT FROM AUTHOR]

Individuals with genetic disorders present with multisystem, complex, and special health care needs. Although limited treatment options are available for most genetic conditions, ensuring continued ongoing surveillance and rehabilitative care is quintessential for improving their quality of life. Delivering comprehensive health-care directed at periodic surveillance, timely diagnosis, and specialized management of these individuals warrants ongoing evaluation and management by specialists in multiple disciplines. Multidisciplinary team approach involving coordinated care among various specialties with a patient-centric outlook ensures efficient resource utilization and cost-effective management. The establishment of "one-stop" multidisciplinary specialized clinics providing comprehensive care is expected to improve the quality of patient care and reduce the overall burden on the family. [ABSTRACT FROM AUTHOR]

Baseline child characteristics may predict treatment outcomes in children with or at elevated likelihood of developing autism (EL-ASD). Little is known about the role of child sensory and language features on treatment outcome. Participants were randomly assigned to a parent-mediated intervention or control condition. Analyses explored the relationship between baseline child sensory and language characteristics and changes in ASD symptoms over approximately 9 months. Higher baseline sensory hyporeactivity was significantly related to less improvement in social communication (SC) for the treatment group only. More baseline atypical vocalizations were significantly related to less improvement on SC across treatment and control groups. This work provides an initial framework to encourage the tailoring of interventions for EL-ASD children, suggesting sensory reactivity and atypical vocalizations may be useful behaviors to consider in treatment planning. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to describe coping strategies used by parents of children with cleft palate with or without a cleft (CP ± L) during the early development of their children in El Salvador. Design: Qualitative interviews were completed with 16 parents of children born with CP ± L who were 6 months to 6 years old. Parents were questioned about their emotions and coping during eight time periods: prenatal, birth, social interaction before the first surgery, the beginning of surgeries, social interaction after the first surgery, early childhood education (ECE), speech–language therapy, and formal education. Thematic analysis (TA) was used to identify coping strategies as conceptualized by Lazarus and Folkman (1984). Results: Four major themes emerged: (a) experienced emotions related to diagnosis, (b) interpretations related to the birth of a child with a cleft, (c) seeking and experiencing cleft treatment, and (d) social interaction of the children. During prenatal and birth stages, parents used emotion-focused strategies. A few hours to a week after birth, they used problem-focused strategies, which led them in search of treatment. Some parents used avoidance strategies during periods of social interaction before surgery, ECE, and formal education. Socioeconomic challenges impacted access to speech–language therapy. Sociocultural factors, such as discrimination, religion, and folk beliefs, appeared to influence some of the coping strategies used by parents. Conclusions: Problem-focused strategies appear to be helpful in seeking surgical treatments. The emotion-focused strategy of avoidance seemed to have adverse effects in minimizing opportunities for social interaction prior to surgery and early education. [ABSTRACT FROM AUTHOR]

Introduction: A nursing rehabilitation Kardex and reports could act as a framework to facilitate and organize rehabilitation programs. Objectives: This study aimed to design a special Kardex and a structure to rehabilitation nursing reports. Methods: This study was carried out in two phases consisting of literature review and Delphi method in Rofideh Rehabilitation Hospital, Tehran, Iran. In the first phase, a diverse literature review was done. PubMed, Elsevier, Web of Science, and Google Scholar as a search engine were searched using the keywords of Kardex, "nursing report," "nursing note," "nursing rehabilitation," "nursing Kardex" from 2010 to 2020. After a literature review, the first draft of the Kardex was made. In the next step, using the Delphi method, the initial Kardex was sent to rehabilitation nursing experts in four rounds, and their comments were applied on that. Results: The rehabilitation nursing Kardex was prepared after four rounds. The Kardex content included "Evaluation of nutritional needs," "Requirements for daily living," "Patients' education," "Examination of bedsores," "Fall prevention," and "communication with rehabilitation departments (physiotherapy, occupational therapy, and speech therapy)." Conclusion: Rehabilitation Kardex and nursing report sample can be used as a suitable tool to promote patients' independence in rehabilitation centers. [ABSTRACT FROM AUTHOR]

This study documented the standardized tests and informal assessment techniques that school-based speech-language pathologists (SLPs) reported as most helpful for identifying vocabulary deficits and for monitoring progress. Speech-language pathologists (N = 142) working in U.S. public school settings completed an online survey that included multiple-choice, multiple-answer, and open-ended formats. Percentages and frequency counts were reported. For identifying vocabulary deficits, SLPs favored omnibus language tests over vocabulary-specific tests. The most frequently selected informal assessments for identifying vocabulary deficits were language samples and curricular-based measures. For monitoring progress, respondents favored creating their own tasks and using curricular-based measures. Minor differences were noted in the responses of elementary and middle-high school SLPs. Results were compared with evidence-based principles for vocabulary assessment. [ABSTRACT FROM AUTHOR]

This exploratory study examined the experiences with and perceptions of challenging behavior of speech-language pathologists (SLPs) serving preschool and school-age children. The sample consisted of 106 SLPs between the ages of 23 and 68 years, mostly located in the United States. Participants completed a survey of 40 questions about their own personal experiences with challenging behaviors. SLPs reported off-task behaviors to be the most frequently encountered, followed by defiant behaviors, internalizing behaviors, and aggressive behaviors. SLPs perceived the most problematic to be off-task behaviors, followed by aggressive behaviors, internalizing behaviors, and defiant behaviors. SLPs' level of experience was not associated with their perceptions of problem behaviors but was associated with their self-rated behavior management skills. Behavior management training was related to their self-reported behavior management skills. This study provides preliminary data on SLPs' perceptions and experiences with challenging behaviors. [ABSTRACT FROM AUTHOR]

Background & aims: Echolalia, the repetition of one's or others' utterances, is a behavior present in typical development, autism spectrum disorder, aphasias, Tourette's, and other clinical groups. Despite the broad range of conditions in which echolalia can occur, it is considered primarily through a disorder-specific lens, which limits a full understanding of the behavior. Method: Empirical and review papers on echolalia across disciplines and etiologies were considered for this narrative review. Literatures were condensed into three primary sections, including echolalia presentations, neural mechanisms, and treatment approaches. Main contribution: Echolalia, commonly observed in autism and other developmental conditions, is assessed, observed, and treated in a siloed fashion, which reduces our collective knowledge of this communication difference. Echolalia should be considered as a developmental, transdiagnostic, and communicative phenomenon. Echolalia is commonly considered as a communicative behavior, but little is known about its neural etiologies or efficacious treatments. Conclusions: This review is the first to synthesize echolalia from a transdiagnostic perspective, which allows for the direct comparisons across and within clinical groups to inform assessment, treatment, conceptualization, and research recommendations. Implications: Considering echolalia transdiagnostically highlights the lack of consensus on operationalization and measurement across and within disorders. Clinical and research future directions need to prioritize consistent definitions of echolalia, which can be used to derive accurate prevalence estimates. Echolalia should be considered as a communication strategy, used similarly across developmental and clinical groups, with recommended strategies of shaping to increase its effectiveness. [ABSTRACT FROM AUTHOR]

A participant with cleft palate and compensatory articulation errors underwent 75 weeks of treatment using a hybrid telepractice and in-person treatment model. This model improved articulation skills during the study period and offers a starting point for continued exploration of telepractice for the treatment of compensatory articulation errors in cleft palate. [ABSTRACT FROM AUTHOR]

The present case study illustrates the use of explicit text structure intervention for expository reading comprehension with three adolescents with language learning disabilities (LLD). We investigated whether it was feasible to provide direct instruction on the identification of signal words that denote compare–contrast relations between concepts, the purpose and nature of expository text structures, and the use of graphic organizers to assist in retell of target passages and compare–contrast text comprehension. The intervention was effective in improving participants' text structure identification, signal word recognition, and comprehension of compare–contrast text. This preliminary case study demonstrates that a short-term text structure intervention is feasible and can benefit adolescents with LLD who struggle with expository reading comprehension. Implications for clinical and educational services and future directions for research are provided. [ABSTRACT FROM AUTHOR]

This study investigated the effect of the digital Down Syndrome LanguagePlus (DSL+) intervention on vocabulary outcomes through a school-delivered randomized controlled trial. A national sample of first graders with Down syndrome from 91 schools was allocated to an intervention group (n = 50), which received daily intervention for 15 weeks, or a business-as-usual control group (n = 53). The intervention involved picture book sharing and structured tasks and was organized as one-to-one, small-group, and full-class lessons. Children in the intervention group made greater gains than children in the control group in expressive vocabulary breadth (d =.429, CI [.160,.699]) and receptive vocabulary breadth (d =.447, CI [.193,.700]). The outcomes indicate that the novel DSL+ intervention is an effective intervention to increase trained vocabulary among first graders with Down syndrome, and it takes only 15 minutes of effort 5 days a week. [ABSTRACT FROM AUTHOR]

Background: Speech-language pathology services are among the most frequently accessed services for young autistic children. Therefore, understanding the nature of these services, what challenges these clinicians face, and what supports they value is critical for developing appropriate policies and practices that can maximize positive outcomes for children and families. This study had two primary aims. The first was to examine the self-reported assessment and intervention practices of community-based Speech Language Pathologists (SLPs) and communicative disorders assistants (CDAs; who provide services under the supervision of a SLP) in supporting preschool children with suspected and diagnosed autism. The second aim was to identify barriers and supports (facilitators) to providing services in the community using the Consolidated Framework for Implementation Research (CFIR) as a framework. Methods: A cross-sectional online survey was used to collect qualitative and quantitative data from clinicians in Ontario Canada who were providing speech and language services to preschool children with suspected or diagnosed autism. Quantitative data were used to describe clinicians" practices, and qualitative data captured their perspectives on barriers and supports to providing services. Results: A total of 258 clinicians participated in the survey. On average, clinicians reported almost half of the preschoolers on their caseload had either diagnosed or suspected autism. There was consistency across the skill development areas assessed by SLPs, and targeted during therapy sessions, with the top four areas targeted being: foundational social communication, language, play and pragmatics. However, there was wide variation in speech and language assessment and intervention practices reported by this sample of clinicians (i.e., service delivery models, tools or programs used, length and duration of therapy services, level of collaboration with other professionals). Clinicians identified several barriers to providing services: limited funding and time, lack of inter-professional collaboration, difficulty accessing services, community messaging about autism services, family readiness and clinician knowledge. Supports (facilitators) included: access to autism-focused professional development, inter- and intra-professional collaboration, and access to additional supports in the community. [ABSTRACT FROM AUTHOR]