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Background:. The American College of Surgeons' National Surgical Quality Improvement Project-Pediatric Data manages a multicenter dataset for monitoring outcomes in pediatric surgical care. We explored trends in outcomes in the most frequently sampled current procedural terminology codes related to craniofacial and cleft lip and palate (CLP) surgical procedures over a 7-year period. Methods:. We used National Surgical Quality Improvement Project-Pediatric Data on 28,147 pediatric patients who underwent plastic surgical procedures between January 1, 2012, and December 31, 2018. Eighteen relevant current procedural terminology codes were selected and sorted into two procedure groups: CLP and craniofacial. For each group, we explored trends in readmission, reoperation, extended length of stay, morbidity, and racial and ethnic variation. Results:. The proportion of readmissions following CLP repair saw a significant reduction per year (from 3.6% to 1.7%). African American or Black CLP patients had significantly higher rates of readmission and extended length of stay when compared to the overall cohort. Asian and White CLP patients had significantly lower rates of experiencing an extended length of stay. For craniofacial cases, extended length of stay decreased significantly per year (from 7.7% to 2.8%). One possible driver of this change was a decrease in transfusion rates during the study period from 59% to 47%. Conclusions:. Pediatric CLP and craniofacial cases saw significant improvements in safety, as indicated by reductions in readmission and extended length of stay. Given the racial differences observed, especially among CLP patients, continued research to identify and address systems of racism in health care remains a priority.

Purpose: Morphological awareness develops throughout formal schooling and is positively related to later reading abilities. However, there are limited standardized measures available for speech-language pathologists (SLPs) to use when assessing morphological awareness in clinical practice. The purpose of this tutorial is to guide clinicians in choosing between researcher-created measures of morphological awareness to use with their school-aged students., Method: We first summarize previous morphological awareness assessment research and outline important clinical considerations when choosing a morphological awareness assessment for students in early elementary grades and beyond. Second, we highlight item characteristics regarding morpheme type, frequency, shift transparency, and imageability for students in early elementary versus later grades. Third, we discuss the type of tasks (i.e., production, decomposition, and judgment) and administration modes (i.e., oral or written and static or dynamic) available to clinicians assessing the morphological awareness skills of school-aged students. Throughout the tutorial, we reference a hypothetical case study to illustrate how SLPs might apply these suggestions and link morphological awareness assessment to treatment recommendations., Conclusions: This tutorial highlights the importance of including morphological awareness assessments in clinical practice to support oral and written language development. We provide practical guidelines to help SLPs evaluate and choose appropriate morphological awareness assessments for their school-aged students as part of their comprehensive language evaluations and to support intervention planning., Supplemental Material: https://doi.org/10.23641/asha.24545470.

Purpose: We will describe how a multisite research team adapted a language-focused curriculum to be used in a scale-up project. Specifically, we identified underlying principles to modify a Tier 1 whole-classroom language comprehension-focused curriculum to be used as a Tier 2 small-group curriculum with children identified as at risk for low language comprehension, including children with developmental language disorder (DLD)., Method: We discuss how researchers used the following five guiding principles to adapt a curriculum for children at risk for low language comprehension, including children with DLD: (a) increased and ongoing professional development, (b) simplification of language input, (c) increased scaffolding, (d) attention to distributed practice, and (e) materials to support diversity and inclusion., Results: We used these guiding principles to modify a popular language-based curriculum used in schools across the country., Conclusion: This clinical focus article showcases how guiding principles and frameworks for adaptation, within implementation science, can serve as a guidepost for speech-language pathologists and other educators who are adapting or scaling up a curriculum or intervention that was not designed for their target population.

Purpose: School-based speech-language pathologists (SLPs) play an important role in supporting children with reading and writing difficulties. The purpose of this study was to describe the training, experiences, and knowledge of SLPs who work in preschool, elementary school, or middle/high school settings in relation to children with reading and writing difficulties., Method: Preschool and school-based SLPs ( N = 280) participated in an online survey, with items related to preservice and in-service training experiences, experiences and perceptions of competence related to reading and writing assessment and instruction with students on their caseload, and knowledge of reading and writing., Results: The majority of respondents reported limited preservice coursework and clinical training experiences with students with reading and writing difficulties. Many SLPs reported that more than half of the students on their caseload had reading and writing difficulties, but many SLPs (approximately 40%) had poor confidence in their abilities in assessment and intervention with children with reading and writing difficulties., Conclusions: Nearly all SLPs indicated that they would benefit from additional training and experience with children with reading and writing difficulties. We provide some initial suggestions for graduate coursework, clinical training experiences, and tailored professional development., Supplemental Material: https://doi.org/10.23641/asha.21809514.

We examined sixth graders' detection of inconsistencies in narrative and expository passages, contrasting participants who were monolingual speakers (N = 85) or Spanish-English DLLs (N = 94) when recruited in pre-kindergarten (PK). We recorded self-paced reading times and judgments about whether the text made sense, and took an independent measure of word reading. Main findings were that inconsistency detection was better for narratives, for participants who were monolingual speakers in PK, and for those who were better word readers. When the text processing demands were increased by separating the inconsistent sentence and its premise with filler sentences there was a stronger signal for inconsistency detection during reading for better word readers. Reading patterns differed for texts for which children reported an inconsistency compared to those for which they did not, indicating a failure to adequately monitor for coherence while reading. Our performance measures indicate that narrative and expository texts make different demands on readers., Competing Interests: Conflicts of interest The authors have no conflicts of interest to declare.

Most research on early identification of reading disabilities has focused on word reading problems and little attention has been given to reading comprehension difficulties. In this study, we investigated whether measures of language ability and/or response to language intervention in kindergarten uniquely predicted reading comprehension difficulties in third grade. A total of 366 children were administered a battery of screening measures at the beginning of kindergarten and progress monitoring probes across the school year. A subset of children also received a 26-week Tier 2 language intervention. Participants' achievement in word reading was assessed at the end of second grade, and their performance in reading comprehension was measured as the end of third grade. Results showed that measures of language ability in kindergarten significantly added to the prediction of reading comprehension difficulties over and above kindergarten word reading predictors and direct measures of word reading in second grade. Response to language intervention also proved to be a unique predictor of reading comprehension outcomes. Findings are discussed in terms of their relevance for the early identification of reading disabilities., (© Hammill Institute on Disabilities 2014.)

Early and accurate identification of children at risk for reading disabilities (RD) is critical for the prevention of RD within a response to intervention framework. In this study, we investigated the use of universal screening and progress monitoring for the early identification of RD in kindergarten children. A total of 366 children were administered a battery of screening measures at the beginning of kindergarten and progress-monitoring probes across the school year. A subset of children who showed initial risk for RD also received a 26-week Tier 2 intervention. Participants' achievement in word reading accuracy and/or fluency was assessed at the end of first grade. Results indicated that a screening battery containing measures of letter naming fluency, phonological awareness, rapid naming, or nonword repetition accurately identified good and poor readers at the end of first grade. Findings also showed that children's response to supplemental and/or classroom instruction measured in terms of growth in letter naming fluency added significantly to the prediction of reading outcomes., (© Hammill Institute on Disabilities 2013.)

Most assessments of phonemic awareness require speech responses and cannot be used with individuals with severe speech impairments who may use augmentative and alternative communication (AAC). This study investigated the reliability and construct validity of the Dynamic Assessment of Phonemic Awareness via the Alphabetic Principle (DAPA-AP), which does not require speech. In all, 17 adults with mild to moderate intellectual disabilities completed the DAPA-AP, a letter-sound knowledge task, four measures of phonological awareness, and two reading assessments. Results indicated the DAPA-AP was both a reliable and valid assessment of phonemic awareness for this sample. Consequently, the DAPA-AP represents an important step in developing phonemic awareness assessments that have the potential to be suitable for use with a wide range of individuals, including those with SSI.

Some children demonstrate adequate or better reading achievement in early school grades, but fall significantly behind their peers in later grades. These children are often referred to as late-emerging poor readers. In this study, we investigated the prevalence and heterogeneity of these poor readers. We also examined the early language and nonverbal cognitive abilities of late-emerging poor readers. Participants were 493 children who were a subsample from an epidemiological study of language impairments in school-age children. In kindergarten, children were administered a battery of language, early literacy, and nonverbal cognitive measures. Word reading and reading comprehension achievement was assessed in second, fourth, eighth, and tenth grades. Latent transition analysis was used to model changes in reading classification (good vs. poor reader) across grades. Population estimates revealed that 13.4% percent of children could be classified as late-emerging poor readers. These children could be divided into those with problems in comprehension alone (52%), word reading alone (36%), or both (12%). Further results indicated that late-emerging poor readers often had a history of language and/or nonverbal cognitive impairments in kindergarten. Subtypes of poor readers also differed significantly in their profiles of language, early literacy, and nonverbal cognitive abilities in kindergarten. Results are discussed in terms of causal factors and implications for early identification.

Purpose: This study examined the reading achievement growth of children with language impairments (LI) across the school grades. The authors sought to determine whether children with LI demonstrate a delayed, deficit, or cumulative pattern of reading achievement growth when compared with children with typical language (TL)., Method: A group of 225 children with LI and a group of 379 children with TL were identified in kindergarten and were administered multiple measures of word recognition and reading comprehension in 2nd, 4th, 8th, and 10th grades., Results: Confirmatory factor analyses indicated that the constructs of word recognition and reading comprehension were invariant across grades and groups of children with LI and TL. Further analyses indicated that a multiple group latent growth curve analysis was appropriate. This analysis showed that children with LI differed significantly from children with TL in initial level (2nd grade) of word recognition and reading comprehension, but they did not differ significantly in the shape of their growth trajectories., Conclusion: These results are consistent with a deficit model of reading growth in children with LI. Findings are discussed in terms of implications for early identification.

This study examined whether a basic song repertoire of folk-type melodies which can be accompanied with principal triads exists in the senior citizen population and compared this repertoire with that of music therapy students. An audiotape of the tunes of 25 standard songs, assumed in previous research to be known by everyone who has finished 6th grade, was played for undergraduate music therapy students (N = 78) and for healthy, active senior citizens (N = 78). None of the senior citizens had received any music therapy services, although many were involved in music activities such as the senior choir at church. Music therapy majors identified significantly more tunes than did the older listeners. Further analysis indicated that there is a good deal of overlap in the repertoires of these two groups. Sixteen tunes were recognized by 80% of therapy students; 10 songs were recognized by 80% of the seniors; the 10 songs identified by these seniors were 10 of the top 11 identified by the college students ("Kumbaya" was not known by the older listeners). Six songs could not be named by 50% of the students; 7 songs could not be named by 50% of the seniors; these two lists contained five common selections ("Oh Shenandoah," "Kookaburra," "Down in the Valley," "Shalom Chaverim," and "Tinga Layo"). Given the growth of the senior segment of the American population, the expansion of services for them, and the popularity of including music activities among these services, it would appear that music therapy students' basic knowledge of a repertoire of songs which are known to older people and which can easily be accompanied with principal triads is adequate, even though the range of songs which could be identified was broad (11-24) and the mean correctly named was merely 70.82% of a set which other investigators, teachers, and professional organizations have said represent a minimal repertoire for all citizens beyond the 6th grade.