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Background: Concussions are a prevalent health concern, affecting millions of individuals in the United States yearly. Concussion symptomology overlaps with other conditions making diagnosis and management particularly challenging, particularly among individuals with ADHD. ADHD is a neurodevelopmental disorder that affects a significant portion of the adult population. Objective: To enhance our understanding of symptom resolution and identify factors that could influence concussion care management, the purpose of the current study was to examine the recovery trajectory of adults diagnosed with both ADHD and concussion compared to the trajectory of adults who have experienced a concussion but do not have an ADHD diagnosis. Methods: The study included a retrospective chart review of patients treated for concussion at a concussion specialty clinic. Results: The findings of the study revealed no significant differences in history of concussion or recovery time between patients with and without ADHD. It was observed that patients with ADHD had a higher prevalence of anxiety, depression, and other mental health conditions. Conclusions: The findings of the current study underscore the need for additional research to guide the care of patients diagnosed with both ADHD and concussion.

Background: Adverse childhood experiences (ACEs) have long been associated with attention-deficit/hyperactive disorder (ADHD) diagnoses in children; but the data used is now over 6 years old (from 2017 to 2018). Understanding the current landscape of their prevalence and association is needed to capture evolving social, environmental, and economic conditions, and ensure interventions remain relevant to addressing current childhood trauma. Objective: This study provides an updated analysis of the association between ACEs and ADHD using post-acute-COVID-19 pandemic data. Participants and Setting: This cross-sectional study of 10,518 children aged 5 to 17 years old derived data from the 2021 to 2022 National Health Interview Survey (NHIS). Methods: Differences in the prevalence of number (0, 1-3, or 4+) and type of ACEs by ADHD diagnosis were evaluated using Rao-Scott chi-square tests and multivariable logistic regression. All analyses incorporate complex survey weights. Results: In 2021 to 2022, 2,457 (23.3%) of children experienced ACEs and 1,115 (9.9%) had an ADHD diagnosis. Children with ADHD were more likely to experience every type of ACE and were more likely to have 1 to 3 or 4+ ACEs than children without ADHD. Children with 4+ ACEs had higher odds of having an ADHD diagnosis (aOR: 3.44, 95% CI [2.64, 4.49]) than children without ACEs. Male children, children with fair or poor health, and children living in rural counties were more likely to have an ADHD diagnosis, while children of color and uninsured children were less likely. We found the odds ratio of ADHD diagnosis for children with four or more ACEs, compared to those without ACEs, slightly lower than found in Brown et al., 2017's estimate of 3.97 (CI [3.29, 4.80]). These results suggest a consistent association between ACEs and ADHD when comparing pre-COVID data to our post-acute-COVID results. Conclusions: These findings highlight the need for clinicians to consider traumatic stress in ADHD screening. Policymakers and early childhood organizations should encourage early screening and intervention for ACEs to reduce the impacts of ADHD diagnoses.

Objective: Maladaptive daydreaming (MD) is characterized by vivid, excessive fantasy activity that becomes prioritized over other activities and may result in avoidant coping strategies. Little is known about the relationship between MD and internalized stigma in the neurodivergent sample. The current study aimed to examine emotional dysregulation, escapism and self-perception (self-esteem and internalized stigma) as potential determinants of MD in three groups: adults on the autism spectrum, with ADHD, and both diagnoses ("AuDHD"), including their neurodivergent symptoms (autistic traits, empathizing, ADHD symptoms). Methods: A sample of 293 persons (139 with ADHD, 74 on the autism spectrum, and 80 with both diagnoses) completed self-report scales concerning ADHD symptoms, autism spectrum symptoms, empathizing, self-esteem, daydreaming as escapism, emotional dysregulation, maladaptive daydreaming, and internalized stigma. A correlation analysis was implemented. Additionally, a group comparison and quantile regression for the 25th, 50th, and 75th percentile of maladaptive daydreaming in the three groups were executed. Results: The results showed that internalized stigma, emotional dysregulation, escapism, and self-esteem have significant associations with MD in the neurodiverse sample. The ADHD group achieved the lowest scores in emotional dysregulation, discrimination experience, and social withdrawal. The groups did not vary in MD rates, stereotype endorsement, stigma resistance, nonacceptance of emotional responses, and impulse control difficulties. The AuDHD group achieved higher results than the ASD group only in the ADHD symptoms. Quantile regression revealed differences in the predictors of maladaptive daydreaming in the three groups. ADHD symptoms and self-suppression escapism were significant predictors for the higher levels of MD in persons with singular autism or ADHD diagnosis. Conclusion: The results showed no differences in MD rates, although there were significant variations in predictive features among the three samples. The role of internalized stigma and self-esteem was highlighted in the results as significant associates of MD prevalence. These outcomes expand the current knowledge in the context of maladaptive daydreaming, internalized stigma, self-esteem and emotional dysregulation in a neurodiverse sample and allow for proposing clinical applications and further research directions.

Autism is associated with significantly higher rates of internalizing and externalizing disorders compared to neurotypical (NT) individuals. Emotion dysregulation (ED) is prevalent in autistic individuals and has been proposed to underlie both internalizing disorders and behavioral challenges in autism. This study sought to use a meta-analytic approach to examine the magnitude of ED severity in autistic samples compared to NT and other clinical (OC) samples. Following a review of the literature, a total of 35 studies were included in the analyses. In general, when comparing autistic to non-autistic individuals, findings suggest a medium magnitude of difference in ED severity between autistic and comparison groups overall. Subgroup analyses indicate that autistic individuals experience significantly higher ED severity when compared to NT peers. However, when compared to OC peers, the effect is small, suggesting the severity of ED may be more similar between OC and autistic groups. Moderators were also explored, including autistic traits, age, and sex composition. These findings provide integral information about the severity of ED in autistic populations compared to other non-autistic populations, assisting in further clarifying the presence of mental health challenges in autistic youth.

Autistic youth are more likely to experience traumatic events and may be more likely to develop trauma-related symptoms. However, accurately identifying trauma-related symptoms in autistic youth can be challenging. We examined post-traumatic stress disorder (PTSD) and other trauma-related diagnoses in youth with and without autism spectrum disorder (ASD) in a large, pediatric psychiatric emergency department (ED) in a diverse urban setting. Between March 2019 and November 2021, 2728 patients presented at our emergency psychiatric ED. Youth with ASD were 42% less likely to receive trauma-related diagnoses (prevalence ratio 0.58, 95% CI 0.41, 0.80) compared with youth without ASD. One possible explanation for this finding is that trauma-related symptoms are under-detected in youth with ASD during emergency psychiatric evaluations. There is a need for trauma screening and diagnostic instruments specifically tailored to the unique needs of youth with ASD to ensure optimal assessment and care.

Approximately 7% of children live with food allergy, a condition that requires dietary avoidance to prevent an allergic reaction. In this qualitative study, we aimed to understand food allergy-related experiences, beliefs and learning preferences among children with and without food allergies, to inform a school-based, food allergy education program. Data were analysed thematically. We virtually interviewed children in Kindergarten-Grade 8 in Manitoba, Canada, with (n = 7) and without (n = 9) parent-reported, physician-diagnosed food allergies. We identified three themes: Naive reliance on peers and school staff to assist with food allergy management; Limited food allergy knowledge; and, Recommended food allergy curricula: complementary perspective. Our findings will help inform the development of a school-based, food allergy education program, with a long-term goal of minimizing food allergy-related worries and optimizing safety for children with food allergy. Ongoing, school-based food allergy education is needed.

Teachers routinely observe and interpret student behavior to make judgements about whether and how to support their students' learning. Simulated cases can help pre-service teachers to gain this skill of diagnostic reasoning. With 118 pre-service teachers, we tested whether participants rate simulated cases presented in a serial-cue case format as more authentic and become more involved with the materials compared to cases presented in a whole case format. We further investigated whether participants with varying prior conceptual knowledge (what are symptoms of ADHD and dyslexia) gain more strategic knowledge (how to detect ADHD and dyslexia) with a serial-cue versus whole case format. We found that the case format did not impact authenticity ratings but that learners reported higher involvement in the serial-cue case format condition. Bayes factors provide moderate evidence for the absence of a case format effect on strategic knowledge and strong evidence for the absence of an interaction of case format and prior knowledge. We recommend using serial-cue case formats in simulations as they are a more authentic representation of the diagnostic reasoning process and cognitively involve learners. We call for replications to gather more evidence for the impact of case format on knowledge acquisition. We suggest a further inquiry into the relationship of case format, involvement, and authenticity but think that a productive way forward for designing authentic simulations is attention to aspects that make serial-cue cases effective for diverse learners. For example, adaptive feedback or targeted practice of specific parts of diagnostic reasoning such as weighing evidence.

Given the interdisciplinary influences on school psychology along with its requirement to comply with federal and state law in the United States, scientific progress in the area of cognitive assessment and specific learning disabilities (SLD) identification has experienced slow, if not stagnant, progress. Extrapolation of research from one discipline to that of assessment is common in school psychology where test authors and creators of interpretive and diagnostic systems make theoretical and empirical justification for their claims with correlational research and factor analysis. Although these methodologies may appear to support an underlying theory or interpretive approach, they can produce divergent results depending upon sample size and methodological choice. Consequently, greater replication and reproduction is required. Federal and state law in the United States may perpetuate low value practices among practitioners who view them as acceptable since they are legal. School psychology does not have regulatory agencies to oversee practices. All of these influences impinge on scientific progress in cognitive assessment and SLD identification. Fortunately, Canada is not beholden to omnibus special education law so its academic institutions and agencies (e.g., school districts) may be better poised to engender scientific progress in cognitive assessment and SLD identification.

Over the past 20+ years, researchers have worked toward identifying early behavioral predictors of autism spectrum disorder (ASD) and developing observation-based screeners to supplement existing parent-report methods. This study is a follow-up, 3 to 8 years later, with parents/caregivers of 57 children previously enrolled in a U.S. university-based study evaluating early ASD-risk. The original study evaluated infants' (ages 15-35 months) ASD-risk through both observation-based and parent-report screeners. At follow-up, caregivers completed a phone interview inquiring about their child's developmental progress and diagnostic outcomes. Results indicated screener at-risk status agreement in infancy predicted only one of the four parent-reported ASD diagnoses at follow-up. Single instrument at-risk status aligned with two additional ASD diagnoses (one per screener), and both screeners missed one ASD diagnosis at follow-up. Results did not indicate significant added utility for the observation-based screener over the commonly used parent-report screener, suggesting that ASD behavioral markers may be hard to observe at early ages.

Since autism diagnosis is directly linked to the availability of supportive services, identifying best practices for early diagnosis of autism has long been a concern of professionals and families. Meanwhile, studies show persistent racial disparities in autism diagnosis. Although numerous clinical diagnostic guidelines have been published, there is not enough discussion of diagnostic procedures through the lens of culturally diverse families. Purpose: This study focuses on the autism diagnostic experiences that Korean immigrant mothers had with their children. Methods: Eleven first-generation Korean-American mothers of children with autism were included in the study. The data was collected using semi-structured interviews in Korean. Results: The main five factors (i.e., cultural beliefs and values, language barriers, complex emotions, immigration and navigating systems, and facilitators and assets) that mainly influence the diagnosis process were identified through thematic analysis. Conclusion: Dynamics are interactive within and between the factors, influencing the entire diagnostic process by either delaying or facilitating the identification of a child's autism and the provision of treatment.

Objective: Attention Deficit Hyperactivity Disorder (ADHD) is a common co-occurring condition in autistic individuals. ADHD is sometimes first recognised in young adulthood because ADHD symptoms may be misattributed to autism due to superficial overlap in presentation and diagnostic overshadowing. It should be investigated whether ADHD questionnaires are accurate in screening symptoms in young adults with autism. The current study examined this. Methods: Participants were autistic young adults (N = 119) who took part in the Special Needs and Autism Project (SNAP), a population-based cohort. ADHD research diagnoses were obtained through the parent-informed Young Adult Psychiatric Assessment. Parents and young adults (self-report sample N = 71) completed ADHD questionnaires (Aberrant Behavior Checklist hyperactivity/non-compliance subscale, Conners Adult ADHD Rating Scales ADHD Index, and Strengths and Difficulties Questionnaire ADHD subscale). Receiver operating characteristic analyses were conducted to explore if the questionnaires discriminated ADHD cases from non-cases. To assess whether results varied by intellectual functioning, subgroup analyses were completed for those with an IQ = 70 vs. <70. Results: Weighted ADHD rates were high. Overall although the measures were performing at or close to adequate levels (area under the curve was 0.66 to 0.79 for parent-report and 0.70 to 0.65 for self-report), no single measure met adequate thresholds for sensitivity and specificity simultaneously. Tool performance was not different for those with an IQ = 70 vs. <70. Conclusion: No single measure reported adequate performance for distinguishing ADHD from non-ADHD cases in this sample of young autistic adults. Use of current thresholds may lead to under-diagnosis.

The present study explored the role race-related barriers and practical barriers to treatment participation play in treatment effectiveness and satisfaction among Black families with autistic youth using a mixed-method approach. In a sample of Black caregivers with autistic youth (N = 101), multiple regressions were conducted to examine the impact of reported racial and practical barriers on parental stress, treatment effectiveness, and treatment satisfaction. Caregivers provided further narratives on their experience navigating diagnostic and treatment services in qualitative interviews. The study demonstrated that Black caregivers of autistic youth are still encountering several racial and logistical barriers when seeking treatment and diagnostic services for their children. These barriers negatively impact caregiver stress and caregiver perceived treatment quality. Contrary to the barriers and stress experienced by Black caregivers, caregivers are generally satisfied with the treatments they are utilizing and find them helpful. The narratives told by caregivers further elucidate the tumultuous experiences of Black caregivers as they seek diagnostic and treatment services for their children. An experience that may be worsened by family, professional, and systemic barriers, and can be improved by advocacy, acceptance, peer and community support, and increased knowledge. Black families of autistic youth call for increased compassion, support, training, and humility among professionals who serve autistic youth.

This study aimed to replicate and extend findings from the only known study that has conducted latent profile analysis of developmental profiles, measured by the Battelle Developmental Inventory, for children in Early Intervention (EI). Children (N = 57,966) who were enrolled in Massachusetts EI sites between 2011 and 2019 and completed a Battelle assessment at EI entry were included. Replicating previous findings, child Battelle profiles were best classified with four latent classes which were largely consistent with previously observed patterns (i.e., domain means within/between classes). Classes were labeled: "Marked communication delay, relative motor strength," "Communication delay, and average motor functioning," "Cognitive and motor delays, relative adaptive strength," and "Consistent mild delays." We described associations between class and sociodemographic factors and autism spectrum disorder (ASD) diagnosis. We found large effects of age and ASD. Two profiles that demonstrated communication delays were associated with older age. The "Marked communication delay" profile was associated with an elevated likelihood of ASD. Results suggest that Battelle developmental profiles may be an additional indicator to improve the identification of ASD in community settings and that profile membership could guide tailored interventions for specific developmental needs. Continued research will help determine whether class membership is stable and associated with differential response to EI.

This research aimed to compare the sleep quality and problematic internet use (PIU) of adolescents diagnosed with attention deficit hyperactivity disorder (ADHD) compared to the group of healthy control. There were 53 ADHD-diagnosed individuals (19 ADHD- combined type, 34 ADHD- inattentive type) in the research population, ages 12 to 18, and 53 healthy adolescents in the control group. A child psychiatrist applied the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL) to each case, and sociodemographic information was collected. The Pittsburgh Sleep Quality Index (PSQI) and the Internet Addiction Test (IAT) were also applied to all the cases. The Turgay DSM-IV-Based Disruptive Behaviour Disorders, Child and Adolescent Evaluation and Screening Scale (T-DSM-IV-S) was completed by the parents of all the adolescents. The ADHD group's IAT and PSQI total points were found to be statistically significantly higher than those of the healthy control group (p < 0.001). The results of the covariance analysis showed a significant positive correlation between the T-DSM-IV-S subscales and the IAT mood points in the ADHD patients. The T-DSM-IV-S attention deficit points were found to be significantly higher in the ADHD children with PIU (independently of age and gender) compared to those without PIU. The results of the study showed that adolescents with ADHD had greater rates of poor sleep quality and PIU than the control group. The study results also suggested that the severity of the inattentive subtype of ADHD could play a potential role in the development of PIU in children diagnosed with ADHD. Based on this foundation, it is crucial to acknowledge and address poor sleep quality and PIU in adolescents with ADHD.

Individuals with disabilities often face discrimination due to negative attitudes from others around them. This is true for youth with specific learning disorders (SLD), whose experiences of discrimination can increase the risk for developing mental health concerns. The current study explored whether the presence of an SLD comorbid with mental health concerns and attitudes toward SLD may have an association with clinical decision-making in counselor trainees. The study additionally investigated the role of contact and experience in attitudes and decision-making patterns. Seventy graduate students enrolled in mental health-related programs at a public university in the southern United States participated in the survey study. Findings showed that SLD had an association with clinical decision-making, with counselor trainees rating a vignette depicting a youth with SLD as having more severe mental health concerns than a vignette without an SLD.

Background: Phonetic transcription is a core skill of speech and language therapists/pathologists (SLT/Ps) for clinical assessment of speech sounds and/or errors, and linguists for investigation of phonetic phenomena in various languages; hence, it is included in the curriculum of the corresponding degree programme. Many experts and course instructors have discussed their opinions on different aspects of phonetic transcription teaching and/or reported their own training programmes. However, no review has systematically summarized the types of expert recommendations and training methodology reported in the literature. Such information is important for mapping the knowledge gaps, refining current teaching and planning further research. Aims: To systematically summarize (1) the materials and procedures for delivering and evaluating phonetic transcription training programmes, and (2) the opinions from experts in phonetic transcription teaching regarding but not limited to the content, rationale(s), format and structure, and timing of teaching phonetic transcription of typical speech and/or disordered speech reported in the literature. Methods & Procedures: A scoping review was carried out by following the Joanna Briggs Institute methodology. PubMed, EBSCOhost and Web of Science were searched and citation searching of included papers was completed. The included papers were divided into training programme reports, of which data (e.g., type and number of speech stimuli used, type and number of learners, outcome measures) were charted, and expert opinion papers, analysed using content analysis. Main contribution: A total of 565 studies were retrieved. After excluding duplicates and irrelevant papers and merging two sources that reported the same training, a total of 23 sources on training programmes and six opinion papers were analysed. Most training were for English and for SLT/P students, with some for the linguistics students. There are variations in the training content (with phonetic transcription practice as the main procedure), delivery mode (some presented via websites or computer software), stimuli (audio recordings of typical adults and children with speech disorders were most used), feedback (mostly immediate feedback using answer keys) and outcome measures (mainly transcription accuracy of learners and user opinions). Content analysis of opinion papers determined five main categories: rationale for training; aspects of the delivery of training; transcription; problem areas noted; and strategies/resources. Conclusions & Implications: Implications and considerations for teaching are discussed, along with recommendations for research in the design of evidence-based training. The findings can contribute to the development of general guidelines about phonetic transcription training in educational programmes and the establishment of pre-registration competencies.

Background: Based on stakeholder conversations, speech and language therapists have anecdotally observed cases of dysphagia with suspected laryngeal hypersensitivity. These presentations have been coined as 'muscle tension dysphagia' often with concurrent laryngeal sensitivity symptoms. However, the role of laryngeal hypersensitivity in dysphagia is not fully understood. Knowledge user engagement highlights a lack of clarity around diagnosis and investigative approaches, limited clinical guidance and inconsistent practice, which leads to inequity in service delivery and care. Aim: To identify and present the published literature regarding the definitions and clinical identification tools used during the management of laryngeal hypersensitivity related dysphagia. Methods & Procedures: A scoping review was conducted following Joanna Briggs Institute methodology and EQUATOR PRISMA-ScR guidance. Patient and stakeholder engagement was embedded at each review stage. The protocol was registered with the Open Science Framework: DOI 10.17605/OSF.IO/CUXYN. A multidatabase search strategy identified literature published between 2012 and 2022. A narrative description was used to report the study findings. Outcomes & Results: The search identified 2590 citations. The full paper screening was completed on 88 studies, with 17 studies included in data extraction. There was a wide range of terminology and assessment approaches which varied across different clinical settings. The most cited term was 'muscle tension dysphagia'. The most common assessments tools were videofluoroscopy, fibreoptic endoscopic evaluation of swallowing and videostroboscopy, predominantly used in speech and language therapy and/or Ear, Nose and Throat settings. Gastroesophageal and respiratory investigations were less frequently cited. Main Contribution: This review details the current evidence related to the terminology and assessment tools cited in laryngeal hypersensitivity related dysphagia to improve clinician knowledge and understanding. Patient and stakeholder involvement indicated that future research needs to: optimize consensus of terminology, and improve consistent identification methods, service provision and treatment approaches. Conclusions & Implications: This review highlights the lack of consistent terminology across the literature. A wide range of assessment tools report nonspecific positive clinical features and a lack of significant instrumental assessment findings. Patients and stakeholders identify the research priorities should improve clinician awareness, knowledge, guidance and evidence to support patient care.

Background: Published best-practice guidelines and standardized protocols for voice assessment recommend multidisciplinary evaluation utilizing a comprehensive range of clinical measures. Previous studies report variations in assessment practices when compared with these guidelines. Aims: To provide an up-to-date evaluation of current global multidisciplinary practice patterns and the opinions of otolaryngologist, ear, nose and throat (ENT) and speech-language pathology (SLP) clinicians on initial assessment and differential diagnosis of adults with voice disorders (VDs). Methods & Procedures: ENTs and SLPs worldwide who had worked with VDs within the last 10 years completed an anonymous online survey. Themes explored demographic information about the clinical practice, information about diagnostic assessment pathways, clinical assessments routinely used for initial voice evaluation and clinician perceived value of clinical assessments important for diagnosis. Outcomes & Results: Patterns in the clinical practice of 88 SLPs and 21 ENTs from 18 countries with 1 to more than 25 years' experience were analysed. Clinicians provided services across a range of locations, and a range of assessment pathways was available for initial evaluation. Case history, laryngoscopy and auditory-perceptual measures were the most frequently selected assessments. Most clinicians favoured formal assessment measures for auditory-perceptual evaluation. Clinicians placed equal weighting on ENT and SLP assessment to aid diagnosis for muscle tension VDs and functional neurological voice disorders (FVDs). Conclusions & Implications: Practice patterns for initial diagnostic voice assessment are largely consistent with the currently published guidelines. Decisions for the selection of assessment tools vary according to VD classification, and assessment decisions appear to be guided by case history. Clinicians are not always following established protocols for obtaining reliable standardized measures. Further research is needed to understand the barriers to adhering to standardized protocols and to develop evidence for the use of case history in the process of VD diagnosis.

Background: Speech in individuals with cleft lip and/or palate (CLP) is a complex myriad of presenting symptoms. It is uniquely associated with the structural difference of velopharyngeal insufficiency (VPI), together with a wide and heterogeneous range of other aetiologies which often co-occur. The nature of the speech sound disorder (SSD) including VPI may also change over the course of an individual's care pathway. Differences in terminology and approaches to analysis are currently used, resulting in confusion internationally. Additionally, current diagnostic labels and classification systems in SSD do not capture the complexity and full nature of speech characteristics in CLP. Aims: This paper aims to explore the different aetiologies of cleft palate/VPI speech and to relate aetiology with speech characteristic(s). In so doing, it attempts to unravel the different terminology used in the field, describing commonalities and differences, and identifying overlaps with the speech summary patterns used in the United Kingdom and elsewhere. The paper also aims to explore the applicability of current diagnostic labels and classification systems in the non-cleft SSD literature and illustrate certain implications for speech intervention in CLP. Methods and Procedures: The different aetiologies were identified from the literature and mapped onto cleft palate/VPI speech characteristics. Different terminology and approaches to analysis are defined and overlaps described. The applicability of current classification systems in SSD is discussed including additional diagnostic labels proposed in the field. Outcomes and Results: Aetiologies of cleft palate/VPI speech identified include developmental (cognitive-linguistic), middle ear disease and fluctuating hearing loss, altered oral structure, abnormal facial growth, VPI-structural (abnormal palate muscle) and VPI-iatrogenic (maxillary advancement surgery). There are four main terminologies used to describe cleft palate/VPI speech: active/passive and compensatory/obligatory, which overlap with the four categories used in the UK speech summary patterns: anterior oral cleft speech characteristics (CSCs), posterior oral CSCs, non-oral CSCs and passive CSCs, although not directly comparable. Current classification systems in non-cleft SSD do not sufficiently capture the full nature and complexity of cleft palate/VPI speech. Conclusions and Implications: Our attempt at identifying the heterogeneous range of aetiologies provides clinicians with a better understanding of cleft palate/VPI speech to inform the management pathway and the nature and type of speech intervention required. We hope that the unravelling of the different terminology in relation to the UK speech summary patterns, and those used elsewhere, reduces confusion and provides more clarity for clinicians in the field. Diagnostic labels and classification require international agreement.

Background: The publication of phase 2 of the CATALISE project in 2017 clarified terminology for children with developmental language disorder (DLD) or delay but unintentionally muddied the water for children with unintelligible speech. A diagnostic label of DLD (phonology) indicates poor prognosis and phonological disorder that persists into middle childhood. However, in contrast to other diagnostic labels that fall under the overarching term of speech sound disorder (SSD), DLD (phonology) does not elucidate the characteristics of the child's speech nor does it point us in the direction of appropriate intervention. Aims: The aim of this paper is to discuss terminology in SSD leading to an evidence-based model which builds on the model of DLD developed in CATALISE, supports descriptive diagnosis and signposts intervention. Methods: Following a focused review of literature proposing or describing terminology for SSD, an expert group of researchers in developmental SSD proposed a revised model of existing terminology. Groups of UK speech and language therapists (SLTs) who provide services for children with SSD were asked to comment on its acceptability and feasibility. Discussion: A three-level terminology model was developed. This comprised an overarching Level 1 term; Level 2 terms that differentiated SSD of unknown origin from SSD with associated or underlying conditions; and specific diagnostic terms at Level 3 to support further assessment and intervention decisions. Consulted SLTs generally expressed agreement with the proposed terminology and a willingness to adopt it in practice. Conclusions: Existing terminology for childhood SSD provides a good basis for clinical decision-making. A modified version of Dodd's (2005) terminology was found to be acceptable to UK SLTs. There is an evident overlap of SSD with CATALISE terminology. However more detailed and specialist terminology than 'DLD (phonology)' is required to support clinical decision-making. It is proposed that endorsement by the UK Royal College of Speech and Language Therapists would obviate the need for a Delphi process.

Background: 'Speech sound disorder' is an umbrella term that encompasses dysarthria, articulation disorders, childhood apraxia of speech and phonological disorders. However, differential diagnosis between these disorders is a persistent challenge in speech pathology, as many diagnostic procedures use symptom clusters instead of identifying an origin of breakdown in the speech and language system. Aims: This article reviews typical and disordered speech through the lens of two well-developed models of production--one focused on phonological encoding and one focused on speech motor planning. We illustrate potential breakdown locations within these models that may relate to childhood apraxia of speech and phonological disorders. Main Contribution: This paper presents an overview of an approach to conceptualisation of speech sound disorders that is grounded in current models of speech production and emphasises consideration of underlying processes. The paper also sketches a research agenda for the development of valid, reliable and clinically feasible assessment protocols for children with speech sound disorders. Conclusion: The process-oriented approach outlined here is in the early stages of development but holds promise for developing a more detailed and comprehensive understanding of, and assessment protocols for speech sound disorders that go beyond broad diagnostic labels based on error analysis. Directions for future research are discussed.

Our goal was to systematically identify, appraise and synthesise the qualitative research on parents' experiences of the autism assessment process. The empirical studies were quality appraised using the Critical Appraisal Skills Programme tool. We synthesised the data using a meta-synthesis approach. Parents' experiences were categorised into four phases namely: the pre-identification phase, the identification process, emotional reactions to the identification of the children as autistic and the post-identification phase. Informed by the social and human rights discourse on disability, we provide recommendations for future research, respecting the rights of all concerned. We discuss the implications of this review for future research into the autism assessment process. Parents consistently mentioned the importance of professional communication and we make recommendations for research on parent-professional partnerships. Given the sensitivities of the issues, we draw attention to ethical considerations when conducting research on the autism assessment process. Finally, we address the strategies that professionals can adopt in applying neurodiversity-affirmative approaches when identifying autistic children and supporting their parents.

Age at autism diagnosis is associated with sex assigned at birth (hereafter, "sex"), such that girls/women are more likely to be delayed or "missed" entirely in the diagnostic process compared to boys/men. Later diagnosed individuals, especially girls/women, demonstrate increased anxious/depressive symptoms. Data on autistic youth from clinic-based (n = 1035; 22.9% assigned female) and sex-balanced research-based (n = 128; 43% assigned female) samples were probed via regression-based mediation models to understand relationships between diagnostic age, sex, and symptoms of anxiety/depression. We hypothesized diagnostic age would mediate the relationship between sex and anxious/depressive symptoms. In both samples, later diagnostic age predicted greater anxious and depressive symptoms, and sex did not directly predict anxious symptoms. In the clinic-based but not the research-based sample, individuals assigned female at birth were later diagnosed than those assigned male, and there was a significant indirect effect of sex on anxious and depressive symptoms through diagnostic age, such that those assigned female and later diagnosed experienced greater symptoms. Within the research-based sample only, sex predicted depressive symptoms. The present study provides an important impetus for further evaluating the implications of diagnostic timing, enhancing tools for recognizing autism in individuals assigned female at birth, and grounding research with real-world ascertainment strategies.

Later autism diagnosis is associated with increased mental health risks. Understanding disparities in diagnostic timing is important to reduce psychiatric burden for autistic people. One characteristic associated with later autism diagnosis is female sex assigned at birth. However, literature to date does not characterize, differentiate, or account for gender identity beyond assigned sex at birth. Gender diversity may be more common in autistic relative to neurotypical people, and autism is proportionally overrepresented in gender-diverse populations. We examined age at autism diagnosis by assigned sex at birth, gender identity, and gender diversity (gender-diverse vs cisgender) status, separately. Three independent cohorts representing different ascertainments were examined: a research-recruited academic medical center sample (N = 193; 8.0-18.0 years); a clinic-based sample (N = 1550; 1.3-25.4 years); and a community-enriched sample (N = 244, 18.2-30.0 years). The clinic-based and community-enriched samples revealed disparities in diagnostic timing: people assigned female at birth, people of female gender, and gender-diverse people were diagnosed with autism significantly later than persons assigned male at birth, persons of male gender, and cisgender persons, respectively. Birth-sex, gender identity, and gender diversity may each uniquely relate to disparities in autism diagnostic timing. The influence of ascertainment strategies, particularly in studies examining assigned sex at birth or gender identity, should be considered.

Background: Research suggests that people with intellectual disabilities have a higher risk for cardiovascular disease than the general population. The aim of this study was to identify barriers for the prevention, diagnosis, and treatment of cardiovascular disease for people with intellectual disabilities. Method: We conducted individual interviews with relatives and general practitioners and focus group interviews with staff working at an assisted home facility, a cardiac ward, an obesity clinic and two rehabilitation centres (n = 33) in Norway. Inductive approach and thematic analysis were used to analyse the data. Results: We identified barriers on an individual and a structural level. The underlying reason for these barriers is that health problems, such as cardiovascular disease, are regularly overlooked as the condition of intellectual disability "overshadows" other possible diagnoses. Conclusion: This focus on intellectual disability rather than other explanations leads to shortcomings in the prevention, diagnoses, and treatment of cardiovascular disease in this group.

When observing other people during naturally paced and dynamic interactions, it is essential to look at specific locations at the right time to extract a maximum of socially informative content. In this study, we aimed to investigate the looking behavior of typically developing toddlers and toddlers later diagnosed with autism when observing other children interact. The sample consisted of 98 toddlers; 22 in a low-likelihood of autism group, 60 in an elevated likelihood of autism group who did not receive a subsequent diagnosis, and 16 in an elevated likelihood group who did receive an autism diagnosis. Participants performed an eye tracking task at 18 months of age and were assessed for diagnostic outcome at 36 months. The video stimuli consisted of two children interacting, where a boy reaches out for a toy and a girl refuses to give it to him. The low likelihood group showed an expected increase in ratio of looking at the girl's face after the boy requested the toy, as compared to before (t(21) = -3.337, p = 0.003). Toddlers with later autism showed a significantly lower ratio of looking at the girl's face during this time window, as compared to the other groups (F(2,91) = 3.698, p = 0.029). These findings provide new leads on how social gaze may be different in children with autism in everyday life (e.g., kindergarten), and highlight the need of studying the dynamics of gaze on short time scales.

Purpose: Disorders on the autism spectrum have characteristics that can manifest as difficulties with communication, executive functioning, daily living, and more. These challenges can be mitigated with early identification. However, diagnostic criteria has changed from DSM-IV to DSM-5, which can make diagnosing a disorder on the autism spectrum complex. We evaluated machine learning to classify individuals as having one of three disorders of the autism spectrum under DSM-IV, or as non-spectrum. Methods: We employed machine learning to analyze retrospective data from 38,560 individuals. Inputs encompassed clinical, demographic, and assessment data. Results: The algorithm achieved AUROCs ranging from 0.863 to 0.980. The model correctly classified 80.5% individuals; 12.6% of individuals from this dataset were misclassified with another disorder on the autism spectrum. Conclusion: Machine learning can classify individuals as having a disorder on the autism spectrum or as non-spectrum using minimal data inputs.

Purpose: Restricted and repetitive behaviours are a core feature of autism diagnoses but have not been widely studied in adulthood. This study examined the rates of and associations between repetitive behaviours and sensory sensitivity in autistic and non-autistic adults; and whether repetitive behaviours described as "stimming" impacted coping with difficulties (self-efficacy). Methods: Diagnosed autistic (n = 182), undiagnosed autistic (n = 163) and non-autistic (n = 146) adults completed online measures of repetitive behaviours, sensory sensitivity, and self-efficacy for when able and not able to stim. Results: Repetitive behaviours and sensory sensitivity correlated significantly in each group, although ratings were higher in autistic compared to non-autistic groups. When people were able to stim, no differences between the groups were observed on self-efficacy ratings. However when unable to stim, autistic people reported lower self-efficacy than non-autistic people. Conclusions: Results suggest that repetitive behaviours are significantly associate with sensory sensitivities. Rather than repetitive behaviours being viewed as negative, stimming was associated with increased self-efficacy. Results suggest that stimming may have beneficial effects. Further work is needed to better understand how repetitive behaviours and stimming manifest in adulthood, how they change over time and their effects for autistic adults.

Participation in Organised Extracurricular Social Activities (OESA) can provide positive outcomes for children. This study investigated whether children aged 4 to 12 years diagnosed with autism differ in their OESA participation and experience compared to neurotypical peers. Parents of autistic children (n = 35) and those of neurotypical peers (n = 171) responded to questions that asked them to reflect on their child's participation and experiences in OESAs. Parents of autistic children reported significantly less OESA participation compared to parents of neurotypical children. Additionally, when evaluating factors that facilitated OESA participation, parents of autistic children rated their child's individual abilities and behaviour, the OESA's features, and the social environment less positively, compared to parents of neurotypical children. OESA participation and experiences differ for autistic and neurotypical children. This study identifies factors that can be adjusted to mitigate this difference.

Use of telehealth assessments for toddlers at increased likelihood of autism spectrum disorder (ASD) began prior to the global COVID-19 pandemic; however, the value of telehealth assessments as an alternative to in-person assessment (IPA) became clearer during the pandemic. The Naturalistic Observation Diagnosis Assessment (NODA™), previously demonstrated as a valid and reliable tool to evaluate asynchronous behaviors for early diagnosis, was enhanced to add synchronous collection of behaviors to assist clinicians in making a differential diagnosis of ASD. This study was conducted to validate the information gathered through NODA-Enhanced (NODA-E™) as compared to a gold standard IPA. Forty-nine toddlers aged 16.0-32.1 months of age, recruited through community pediatric offices and a tertiary ASD clinic, participated in both NODA-E and IPA assessments. There was high agreement between the two assessment protocols for overall diagnosis (46 of 49 cases; 93.6%; [kappa] = 0.878), specific diagnostic criteria for social communication and social interaction (SCI; range 95.9-98%; [kappa] = 0.918-0.959), and for two of four criteria specified for restricted and repetitive behaviors (RRB; range 87.8-98%; [kappa] = 0.755 and 0.959). There was lower agreement for two subcategories of RRBs (range 65.3-67.3%; [kappa] = 0.306 and 0.347). NODA-E is a tool that can assist clinicians in making reliable and valid early ASD diagnoses using both asynchronous and synchronous information gathered via telehealth and offers an additional tool within a clinician's assessment toolbox.

Identifying gifted students in today's complex context requires precision in both the definition of the concept and its constituent characteristics. However, there are discrepancies worldwide in the instruments established to diagnose gifted students. This study undertook a systematic literature review (SLR) to identify the most representative characteristics of this profile. A database of 676 articles from Scopus and WoS was analyzed, of which 37 were screened for further study using a content analysis approach. The study aimed to answer two research questions: (1) What are the prevailing characteristics of research on giftedness? (2) What are the challenges and barriers to current research and practice in gifted research? These inquiries were addressed through a series of disaggregated questions divided into four categories: publication metrics, study methodology, identification and support of giftedeness, and technology used. The main findings were a) the lack of standardized measures for identifying gifted individuals; b) the important role of teacher training in identifying and supporting gifted profiles; and c) the inherent limitations of research on giftedness, which constrain the generalizability of its findings. It was concluded that emotional intelligence plays a critical role in giftedness. Key challenges identified include discrepancies in giftedness identification instruments and the impact of cultural and socio-economic factors on gifted education.

Background: In Malaysia, the mortality from melioidosis infection was reported to be higher than in other infectious diseases. The research on melioidosis is still limited in Malaysia but slightly increasing. Objectives: The objective of the study was to give an overview of the study designs, statistical methods, and comparison of research in identifying the predictors of melioidosis mortality in Malaysia between January 2010 to December 2021. Data sources: Pubmed/Medline. Study eligibility criteria: Original English-language articles were abstracted. The articles that identified the predictors of melioidosis from mortality in Malaysia only included. Letters to the editor, editorials, reviews, systematic reviews, meta-analysis, case reports, and any other ineligible articles were excluded. Results: A total of eight studies were identified related to predictors of melioidosis mortality in Malaysia. From the selected articles, 87.5% were retrospectively collected. Five out of eight articles (62.5%) used the logistic regression in identifying the predictors of melioidosis mortality. Only one (12.5%) used advanced survival analysis methods of Cox regression analysis. Another 25.0% used Chi-square test. Conclusions: Logistic regression methods remain the most common methods of analysis in publications on predictors of melioidosis mortality in Malaysia while retrospective research designs are preferred. There is a limitation of research in predictors of melioidosis mortality and the use of advanced statistical techniques reported using the melioidosis data in Malaysia. More published research on melioidosis will provide input to the clinicians on a more detailed understanding of how to improve the diagnosis of melioidosis and the prognosis factors of this disease.

This paper presents a systematic literature review aimed at consolidating knowledge on the application of eye-tracking technology in the diagnosis of dyslexia among school-aged children (6-12 years). Through a meticulous search and selection process, 20 studies conducted over the last 10 years were identified and analyzed to evaluate the effectiveness of this technology. The findings highlight the varied methodologies, participant demographics, and outcomes of these studies, underscoring the potential of eye tracking as a non-invasive, objective tool in the early detection of and intervention for dyslexia. Despite facing limitations such as heterogeneity in study designs and the need for standardized protocols, this review illuminates the significant promise of eye-tracking technology in enhancing dyslexia diagnosis. It identifies gaps in current research, proposes avenues for future investigation, and offers evidence-based recommendations for practitioners. This endeavor not only enriches the present understanding of dyslexia diagnosis, but also establishes a foundation to ultimately improve educational outcomes for dyslexic learners.

Parents play a vital role in supporting children with learning disabilities, but little is known about their understanding of this diagnosis. The experiences of parents with the diagnostic process and the services their children receive post-diagnosis vary widely. Parents who participated in this study reported that they understand learning disabilities broadly but not their underlying neurobiology. Those who noted understanding the neurobiology indicated that it helped them better support their child, and those who did not understand it wanted to learn more. Parents generally noted that their children received less support during COVID-19 and that they had to seek more private services in order to support their child's academic progress, which caused additional strain on families. Finally, parents reported that having a child with a learning disability negatively affected their mental health, especially when parents feel like they have had to advocate strongly for their child to receive services.

This study aimed to explore the influence of case-based learning (CBL) on the clinical reasoning of new graduate occupational therapists. A quasi-experimental single-arm study with a convergent mixed methods approach was conducted. The intervention was the 10-week CBL program, which included (1) guidance and mentorship in clinical practice and (2) case reports and presentations. Quantitative data collection consisted of the self-assessment of clinical reasoning in occupational therapy (SA-CROT) and the professional identity scale (PI scale); paired t-tests were conducted (p <0.05). The qualitative data collection was through a questionnaire with one open-ended question and reflexive thematic analysis was performed. The quantitative analysis results indicated that the CBL program improved the total score of the SA-CROT (p = 0.001, effect size r = 0.65), and all four of the SA-CROT's subfactors indicated improvement with moderate to large changes. In addition, the PI scale's two subfactors improved. Qualitative analysis revealed that the CBL program was an experience of "learning multidimensional thought processes" and "learning skills to improve clinical reasoning themselves" for participants. This study's results provide information on the positive influence of CBL on the clinical reasoning of new graduate occupational therapists and highlight the integration of the CBL program into continuing education, the importance of supervisors' guidance and mentorship, and learners' reflection and verbalization of clinical practice.

Attention-deficit/hyperactivity disorder (ADHD) is America's most common childhood disorder. Although an ADHD diagnosis can bring positives, recent research uncovers potential negatives associated with diagnosis. This study examines understudied racial-ethnic heterogeneity in the relationships between an early elementary school ADHD diagnosis--with or without medication treatment--and children's future perceived self-competence, teacher-rated school behaviors, and parent-rated educational expectations. Findings are consistent with the notion that diagnosis can trigger racialized patterns of stigma. That is, relative to undiagnosed matches of the same social class and regardless of medication use, diagnosed Black children demonstrate worse teacher-rated school behaviors, diagnosed White children report poorer perceived self-competence, and parents of diagnosed Hispanic children report poorer educational expectations. Racialized patterns of stigma might amplify the consequences of negative-ability stereotyping on Black children, academic pressure on White children, and mental health stigma on Hispanic children. Findings also highlight the challenges of identification posed by differential unobserved selection into diagnosis.

Purpose: An official autism diagnosis is required to access timely intervention and is associated with better long-term wellbeing and mental health. Certain demographic characteristics, such as being female or a racially or ethnically minoritized youth, have been associated with significant diagnostic lag. However, it remains unclear how assigned sex, race, and ethnicity interact with each other in predicting the prevalence and age of autism diagnosis. Methods: To examine the interactions between assigned sex, race, and ethnicity, we used data from the National Survey of Children's Health (NSCH; 2016 > 2021). Results: One in 38 children had an autism diagnosis and 3.8 males were diagnosed per 1 female. Hierarchical linear regressions yielded diagnostic delays in some females, particularly those who were non-Hispanic white, Black, and Asian. Ethnic and racial minority children had significantly earlier diagnoses than white and non-Hispanic children when not accounting for sex. Conclusion: This study demonstrates slight increases in reported autism prevalence, a diagnostic lag in some autistic females that was strongly associated with ethnicity, and earlier diagnoses in racial and ethnic minority youth, a finding that may be explained by factors associated with phenotypic differences. This study has important implications for the diagnosis of minority autistic youth, particularly females and females who are non-Hispanic, who may experience a greater propensity for diagnostic delays.

Collectively, Ethiopians and Eritreans represent one of the largest African immigrant groups in the US, yet no research to date exists on families from these communities raising autistic children. The purpose of our study was to examine the experiences of Ethiopian and Eritrean families of autistic children including experiences (1) receiving the autism diagnosis and interacting with healthcare providers, (2) obtaining services and supports for children (including satisfaction with services and barriers to care), and (3) accessing services and supports for caregivers and families (including needs and barriers to care). Ethiopian and Eritrean parents (N = 51) raising autistic children in the US completed an online survey. Parents reported limited prior knowledge of autism within their communities and had varied experiences with healthcare providers through the diagnostic process. They endorsed barriers to accessing care for their child and family supports (such as provider shortages and cost of services), service needs, and dissatisfaction with school-based and behavioral supports. Many parents reported a negative impact on workforce participation in order to meet their child's needs. Parents identified needs that would benefit their autistic children and families, such as accessible support groups to obtain relevant information. To our knowledge, this is the first systematic study exploring the experiences of Ethiopian and Eritrean families raising autistic children in the US. We discuss implications of our findings and recommendations for culturally responsive care.

The capacity of the workforce lags behind the current demand for timely autism diagnostic assessment. Primary care providers (PCPs) are well-positioned to diagnose autism at earlier ages than providers from other disciplines. Thus, bolstering PCPs' diagnostic capabilities has been the focus of many recent capacity-building initiatives. Using data from the National Survey of Children's Health, this study aimed to evaluate whether diagnosis of autism in primary care has changed over time and whether diagnosis in primary care relates to age at autism diagnosis. Results indicated that the likelihood of being diagnosed with autism by a PCP decreased by about 2% with every passing year from 2004 to 2019 when controlling for demographic characteristics. PCPs diagnosed children approximately 1 year earlier than non-PCPs (e.g., psychiatrists and psychologists), which supports the critical role PCPs can play in timely diagnosis. Further research is needed to understand why the proportion of children diagnosed by PCPs has decreased over time; however, these findings suggest that capacity-building initiatives have not yet reached community practice. Future research should focus on the dissemination and implementation of training initiatives in community-based primary care practices.

Autism is a lifelong condition characterized by repetitive and restrictive behaviors and differences in social communication. The reported prevalence of autism has risen exponentially in the past years. Early identification and subsequent early intervention are key to promoting better outcomes for autistic individuals. However, there is a dearth of research focusing on understanding variables that impact the age of diagnosis of autistic children in Paraguay. We collected data from 176 caregivers of autistic individuals aged 18 years or younger who lived in Paraguay and conducted a hierarchical regression analysis to understand whether demographic and clinical variables predicted the age of autism diagnosis in Paraguayan autistic children. Our results indicated that child's age, child's age at caregivers' first concerns for their development, and child's verbal skills were significant predictors of the age of autism diagnosis in Paraguay. Educating caregivers and professionals to increase awareness of autism characteristics and atypical behaviors in social communication beyond verbal skills may support the early identification of autism and subsequent access to early intervention.

Objective: Rates of ADHD are lowest among Asian American children (1-6.1%) compared to all other major ethnic and racial groups in the US, but there is limited literature on reasons for the disparity in estimated prevalence rates. Method: We conducted a narrative review to integrate the literature on ADHD in children in Asian countries with that on ADHD among Asian American youth to highlight potential explanations for disparities in ADHD diagnosis and treatment among Asian American children relative to other racial and ethnic groups. Results: Factors possibly contributing to the low estimated prevalence rates of ADHD among Asian American children include: a higher proportion of Inattentive ADHD presentation among Chinese, Malaysian, and Indian children; racial bias and the influence of the Model Minority Myth; cultural differences in classroom identification; mental health stigma in Asian American communities; parent perception of ADHD as misbehavior rather than a neurodevelopmental disorder; and parent support for children's academic activities that may mask impairment. Conclusion: We offer recommendations to inform individual and community-level psychoeducation, and new directions for research to address this health disparity.

Objectives: Assessing functional impairment is one of the essential components in the clinical evaluation of ADHD in adulthood, serving both diagnostic and outcome evaluation purposes. However, clinicians and researchers may face challenges in selecting suitable instruments due to variations in accessibility and quality of instruments. Methods: We conducted an online survey involving an international group of 92 respondents engaged in clinical practice and/or research on ADHD. The survey aimed to evaluate current practices in assessing impairment in adult ADHD and related disorders, while also identifying areas requiring adaptation or potential new developments. Results: Our findings revealed that clinicians and researchers utilize a diverse range of instruments for assessing impairment in adults with ADHD, including some that may lack adequate properties for this purpose. Notably, dissatisfaction with current practice standards was expressed, underscoring the need for novel assessment approaches and improved psychometric properties. Conclusion: It is evident that research endeavors are warranted to either refine existing measures or devise new ones for assessing functional impairment in adult ADHD. Emphasis should be placed on disseminating instruments that enhance accessibility in both research and clinical settings, and facilitate streamlined administration and interpretation.

We address defining and identifying students with dyslexia within the context of multi-tier systems of support (MTSS). We review proposed definitions of dyslexia, evidence for proposed definitional attributes, and emphasize the role of instructional response in identifying students with dyslexia. We identify dyslexia as individuals with specific deficits in reading and spelling single words combined with inadequate response to evidence-based instruction. We propose a hybrid identification process in which assessment is utilized within school-wide MTSS allowing for integration of routinely collected progress monitoring data as well integrating with more formal diagnostic measures. This proposed "hybrid" method demonstrates strong evidence for valid decision-making and directly informs instruction. We close proposing a revised definition of dyslexia that incorporates these elements.

Background: Communication disabilities, such as primary progressive aphasia (PPA), impact family members as well as the individuals with the condition. To provide adequate communication care to people with PPA (PwPPA) and their family members, it is crucial to understand the communication needs from the family members' perspectives. To date, research on the communication needs of people with primary progressive aphasia and their family members from the perspectives of family members has been limited. Aims: The specific research objectives were to explore (a) the communication needs pertaining to PwPPA in the early, middle and late stages; and (b) the communication needs pertaining to family members of PwPPA in the early, middle and late stages, from the perspectives of family members. Methods & Procedures: This study employed a qualitative description approach, underpinned by the pragmatic paradigm. Data collection involved semi-structured qualitative interviews with eight family members (relatives of four individuals with the logopenic variant of PPA, of two individuals with the nonfluent variant of PPA, of one individual with the semantic variant of PPA and of one individual with mixed PPA). Qualitative content analysis was used to identify codes and categories in relation to the research objectives. Outcomes & Results: Qualitative content analysis revealed eight categories of communication needs pertaining to the PwPPA: person-specific needs; diagnosis and disclosure; general communication difficulties; impact on communication in everyday life; impact on cognition; impact on psychosocial well-being; impact on person's dignity and autonomy; and future planning. Six categories were identified pertaining to the family members: information about and awareness of PPA; impact of communication difficulties on family/others; increased responsibilities for the family in everyday life; impact on psychosocial well-being; and future planning. Conclusions & Implications: This investigation has expanded our knowledge in the area by providing insights about communication needs which speech-language pathologists and other health professionals should be aware of and take into account when providing communication care to PwPPA and their families.