Search

Background: Indirect speech and language therapy, such as parent-implemented intervention, has been shown to be an effective approach for young children with speech and language disorders. However, relatively few studies have compared outcomes of parent-directed therapy with child-directed intervention, that is, individual therapy of a child delivered by a speech and language therapist (SLT). Although speech and language therapists (SLTs) regard parental engagement as imperative for successful intervention, currently they predominantly use child-directed intervention. Aim: To evaluate the effect of parent- versus child-directed speech--language therapy embedded in usual care intervention for young children with developmental language disorder (DLD). Methods & Procedures: In a randomized trial, forty-six 3-year-old monolingual children with DLD were assigned to parent-directed intervention or child-directed intervention groups. In addition, all children received usual care in special-language daycare centres. Outcomes included children's language development and functional communication, parents' language output, parents' perceptions and their self-efficacy. These were assessed at three time intervals, that is, at baseline, immediately after 6 months of treatment, and 1 year after baseline. The parent-directed intervention consisted of twelve 50-min sessions every 2 weeks with parent and child, consisting of parental training with immediate feedback by (SLTs. Children in the child-directed intervention group received individual speech-language therapy in weekly 30-min sessions for 6 months. Outcomes & Results: Intervention in both groups was equally effective. All children improved significantly in receptive and expressive language measures as well as in functional communication at all intervals. All parents used significantly more language support strategies and were less concerned about their child's participation in communication. Parents in the parent-directed intervention group reported increased self-efficacy in stimulating their child's language development. In contrast, parents in the child-directed intervention group reported a decrease in self-efficacy. Though modest, these group differences were significant in both the short and long terms. Both parents and SLTs were positive about the parent-directed intervention. Conclusions & Implications: The effects of parent- and child-directed intervention for young children with DLD are similar. The parent-directed intervention adds to treatment options for parents as well as for SLTs and creates choices for shared decision-making.

Background: Variations in communicative participation of children with developmental language disorder (DLD) cannot be wholly explained by their language difficulties alone and may be influenced by contextual factors. Contextual factors may support or hinder communicative participation in children, which makes their identification clinically relevant. Aims: To investigate which contextual (environmental and personal) factors in early childhood are protective, risk or neutral factors for communicative participation among school-aged children with DLD, and to identify possible gaps in knowledge about this subject. Methods & Procedures: A scoping review was conducted based on a systematic search of studies published from January 2007 to March 2022 in Pubmed, Embase (without MEDLINE), CINAHL and PsycINFO. In total, 8802 studies were reviewed using predefined eligibility criteria, of which 32 studies were included for data extraction and critically appraised using the Critical Appraisal Skills Programme (2021) tools. Main Contribution: The methodological quality of included studies was adequate to strong. Personal protective factors identified are being a preschool girl, reaching school age and being prosocial, while personal risk factors are becoming a teenager or adolescent, having low socio-cognitive skills and experiencing comorbid mobility impairment or behavioural problems. Gender after the preschool years and non-verbal abilities were not found to be of influence, and the role of socio-emotional skills is inconclusive. Receiving therapy is an environmental protective factor, while the association between socio-economical family characteristics with communicative participation is inconclusive. Conclusions & Implications: Limited research has been conducted on which risk and protective factors present in early childhood are associated with later communicative participation of children with DLD. The influence of co-occurring health conditions, social background variables, individual psychological assets, interpersonal relationships and attitudes of other people represent knowledge gaps. In addition, knowledge about the comparative effectiveness of different types of interventions and service delivery models, and the impact of administrative control, organizational mechanisms and standards established by governments on children's communicative participation is lacking. More longitudinal research is needed focusing on the identification of relevant personal and environmental factors and the interactions between them in relation to communicative participation outcomes.

Background: Early and effective treatment for children with developmental language disorder (DLD) is important. Although a growing body of research shows the effects of interventions at the group level, clinicians observe large individual differences in language growth, and differences in outcomes across language domains. A systematic understanding of how child characteristics contribute to changes in language skills is still lacking. Aims: To assess changes in the language domains: expressive morphosyntax; receptive and expressive vocabulary; and comprehension, in children in special needs education for DLD. To explore if differences in language gains between children are related to child characteristics: language profile; severity of the disorder; being raised mono- or multilingually; and cognitive ability. Methods & Procedures: We extracted data from school records of 154 children (4-6 years old) in special needs education offering a language and communication-stimulating educational environment, including speech and language therapy. Changes in language were measured by comparing the scores on standardized language tests at the beginning and the end of a school year. Next, we related language change to language profile (receptive-expressive versus expressive-only disorders), severity (initial scores), growing up mono- and multilingually, and children's reported non-verbal IQ scores. Outcomes & Results: Overall, the children showed significant improvements in expressive morphosyntax, expressive vocabulary and language comprehension. Baseline scores and gains were lowest for expressive morphosyntax. Differences in language gains between children with receptive-expressive disorders and expressive-only disorders were not significant. There was more improvement in children with lower initial scores. There were no differences between mono- and multilingual children, except for expressive vocabulary. There was no evidence of a relation between non-verbal IQ scores and language growth. Conclusions & Implications: Children with DLD in special needs education showed gains in language performance during one school year. There was, however, little change in morphosyntactic scores, which supports previous studies concluding that poor morphosyntax is a persistent characteristic of DLD. Our results indicate that it is important to include all children with DLD in intervention: children with receptive-expressive and expressive disorders; mono- and multilingual children, and children with high, average and low non-verbal IQ scores. We did not find negative relations between these child factors and changes in language skills.

Purpose: Children with a developmental language disorder (DLD) are often delayed in their grammatical development. This is suggested to be the most important characteristic and clinical marker of DLD. However, it is unknown if this assumption is valid for young children, in the earliest stages of grammatical development. For this reason, this study investigates the complexity, diversity, and accuracy of the grammatical repertoires of 3- to 6-year-old Dutch children with DLD, in comparison to that of typically developing (TD) children matched on grammatical level. Method: Language samples of 59 children (29 children with DLD and 30 TD children) were analyzed using multiple measures of grammatical complexity, diversity, and accuracy. The TD children and children with DLD were languagematched on their grammatical development using the levels of the Dutch version of the Language Assessment, Remediation, and Screening Procedure, the Taal Analyse Remediëring en Screening Procedure (TARSP; Schlichting, 2017). Thus, the children with DLD were significantly older than the TD children (respectively DLD age range: 2;7-5;4 [years;months], M[subscript age] = 4;1; and TD age range: 2;0-3;9, M[subscript age] = 2;9). Results: The results show that children with DLD are comparable to language-matched TD children in their grammatical accuracy and diversity, but that they produce less complex utterances. Conclusions: The results indicate that children with DLD lag behind in their grammatical complexity as compared to language-matched TD children. The results also suggest that grammatical TARSP level is not sufficiently informative for selecting treatment goals. Instead, the results underline the importance of conducting language sample analyses, with special reference to the complexity of the utterances of a child with DLD.

Purpose: Children with a developmental language disorder (DLD) are often delayed in their grammatical development. This is suggested to be the most important characteristic and clinical marker of DLD. However, it is unknown if this assumption is valid for young children, in the earliest stages of grammatical development. For this reason, this study investigates the complexity, diversity, and accuracy of the grammatical repertoires of 3- to 6-year-old Dutch children with DLD, in comparison to that of typically developing (TD) children matched on grammatical level. Method: Language samples of 59 children (29 children with DLD and 30 TD children) were analyzed using multiple measures of grammatical complexity, diversity, and accuracy. The TD children and children with DLD were language-matched on their grammatical development using the levels of the Dutch version of the Language Assessment, Remediation, and Screening Procedure, the Taal Analyse Remediering en Screening Procedure (TARSP; Schlichting, 2017). Thus, the children with DLD were significantly older than the TD children (respectively DLD age range: 2;7-5;4 [years; months], [M.sub.age] = 4;1; and TD age range: 2;0-3;9, [M.sub.age] = 2;9). Results: The results show that children with DLD are comparable to language-matched TD children in their grammatical accuracy and diversity, but that they produce less complex utterances. Conclusions: The results indicate that children with DLD lag behind in their grammatical complexity as compared to language-matched TD children. The results also suggest that grammatical TARSP level is not sufficiently informative for selecting treatment goals. Instead, the results underline the importance of conducting language sample analyses, with special reference to the complexity of the utterances of a child with DLD., Children with a developmental language disorder (DLD) have a language production and/or comprehension impairment that cannot be related to sensory, cognitive, or neurological deficits, an unfavorable psychological condition, or insufficient [...]

Background: Despite the compelling case for engaging parents in speech and language therapy, research indicates that speech and language therapists (SLTs) currently have a leading role in the goal-setting process of therapy for children with developmental language disorder (DLD). Therefore, we set out to develop a tool that aims to support the dialogue between SLTs and parents and enhance shared decision-making about children's communicative participation goals. We used co-design techniques with SLT--practitioners to include their perspectives throughout the design process. Although co-design has been used for some years in healthcare research, it is still a relatively new research methodology in the field of speech and language therapy. Aims: To provide a detailed description of the co-design process that led to the development of a physical artefact that can support SLTs to engage parents of children with DLD in collaborative goal-setting. Methods & Procedures: The Design Council's Double Diamond model was used to develop a tool in co-design, together with eight SLTs, who participated in all stages of the development process. Usability was tested in actual goal-setting conversations between four SLTs and 11 parents of a child with DLD resulting in stepwise improvements. In addition, usability of the first and final prototypes was tested with five usability criteria that were rated on a 10-point scale by 64 SLTs. Outcomes & Results: The co-design process resulted in the development of a physical prototype of the tool called 'ENGAGE', consisting of a metal 'tree trunk' on which parents can stick magnetic 'leaves' containing potential participation goals for their child. The 'tree' shape represents a child's development and opportunities for growth. This first prototype received marks between 7.0 and 8.0 out of 10 on attractiveness, user-friendliness, safety, functionality and affordability. After several iterations, there were significantly higher marks for attractiveness, user-friendliness and safety in favour for the final prototype. Marks for functionality and affordability did not change significantly. Conclusions & Implications: As researchers we usually develop pen-and-paper tools, interview protocols, apps or questionnaires to support clinical practice. Including the SLTs' perspectives in the design process resulted in a tree-shaped physical artefact that, according to the SLTs, helps to order information and encourages and guides their dialogue with parents. We strongly advocate the inclusion of end-users in developing innovative user-centred tools for speech and language therapy and we hope that this will become widespread practice.

Purpose: Most speech-language pathologists (SLPs) working with children with developmental language disorder (DLD) do not perform language sample analysis (LSA) on a regular basis, although they do regard LSA as highly informative for goal setting and evaluating grammatical therapy. The primary aim of this study was to identify facilitators, barriers, and needs related to performing LSA by Dutch SLPs working with children with DLD. The secondary aim was to investigate whether a training would change the actual performance of LSA. Method: A focus group with 11 SLPs working in Dutch speech-language pathology practices was conducted. Barriers, facilitators, and needs were identified using thematic analysis and categorized using the theoretical domain framework. To address the barriers, a training was developed using software program CLAN. Changes in barriers and use of LSA were evaluated with a survey sent to participants before, directly after, and 3 months posttraining. Results: The barriers reported in the focus group were SLPs' lack of knowledge and skills, time investment, negative beliefs about their capabilities, differences in beliefs about their professional role, and no reimbursement from health insurance companies. Posttraining survey results revealed that LSA was not performed more often in daily practice. Using CLAN was not the solution according to participating SLPs. Time investment remained a huge barrier. Conclusions: A training in performing LSA did not resolve the time investment barrier experienced by SLPs. User-friendly software, developed in codesign with SLPs might provide a solution. For the short-term, shorter samples, preferably from narrative tasks, should be considered.

Background: Communication between people with aphasia and their healthcare professionals (HCPs) can be greatly improved when HCPs are trained in using supportive conversation techniques and tools. Communication partner training (CPT) is an umbrella term that covers a range of interventions that train the conversation partners of people with aphasia. Several CPT interventions for HCPs have been developed and used to support HCPs to interact successfully with people with aphasia. Aims: The objective of this study was to identify the mechanisms of change as a result of a Dutch CPT intervention, named CommuniCare, in order to evaluate and optimise the intervention. Methods & procedures: A total of 254 HCPs from five different healthcare centres received CommuniCare. An explorative qualitative research design was chosen. Two interviews were conducted with 24 HCPs directly after and 4 months after receiving the training that was part of CommuniCare. Two conceptual frameworks were used to deductively code the interviews. HCPs' perspectives were coded into a four-part sequence following CIMO logic: the self-reported use of supportive conversation techniques or tools pre-intervention (Context), the intervention elements (Intervention) that evoked certain mechanisms (Mechanisms), resulting in the self-reported use of supportive conversation techniques and tools post-intervention (Outcomes). The Capabilities Opportunities Motivation-Behaviour (COM-B) model was used to fill in the Mechanisms component. Outcomes & results: Three themes were identified to describe the mechanisms of change that led to an increase in the use of supportive conversation techniques and tools. According to HCPs: (1) information, videos, e-learning modules, role-play, feedback during training and coaching on the job increased their psychological capabilities; (2) information and role-play increased their automatic motivations; and (3) information, videos and role-play increased their reflective motivations. Remaining findings show HCPs' perspectives on various barriers to use supportive conversation techniques and tools. Conclusions & implications: HCPs in this study identified elements in our CPT intervention that positively influenced their behaviour change. Of these, role-play and coaching on the job were particularly important. HCPs suggested this last element should be better implemented. Therefore, healthcare settings wishing to enhance HCPs' communication skills should first consider enhancing HCPs' opportunities for experiential learning. Second, healthcare settings should determine which HCPs are suitable to have a role as implementation support practitioners, to support their colleagues in the use of supportive conversation techniques and tools.

The present study aimed to investigate 1) whether country categories and type of DLD predict the type of therapy (direct, indirect, and mixed) the child receives, and 2) whether there is an association between country categories, type of therapy, and type of DLD (receptive, expressive, and mixed). European countries were categorised based on Sapir's typology into Continental, AngloSaxon, Nordic and Mediterranean groups. A fifth group i.e. Central European (including Baltic countries) was added. The data to address these questions comes from an online survey, translated and adapted into 30 languages, and is based on reports by 4685 professionals delivering services for children with DLD. This survey was developed by the COST Action IS1406 members and distributed online among practitioners in the year 2017 across European countries. Results indicated that country categories and type of DLD predicted type of therapy. It was suggested that cultural and contextual factors might play a key role in driving clinical practice above and beyond language profiles, patient characteristics and evidence-based practice. [ABSTRACT FROM AUTHOR]

Purpose: Early detection of language delays is essential, as language is key for academic outcomes, well-being, and societal participation. Previous studies have focused on undetected delays in young children. Much less is known about referrals at older ages. In this study, we aimed to (a) establish how many children are referred at toddler age (2-3 years) and how many at lower elementary (4-7 years), upper elementary (8-12 years), and high school (13-16 years) age; (b) evaluate characteristics of the referred children and adolescents across age groups; and (c) assess whether the ensuing classification (no language disorder [LD], developmental LD, LD + additional problems) differed across age groups. Method: We used the 2010-2014 database of the Dutch federation of speech and hearing centers, containing 18,894 cases with target ages. We established the number of referrals in each age group (Q1) and assessed the composition of the age groups in terms of speech, language, behavioral, and cognitive outcomes (Q2), as well as in terms of classification (Q3). To answer Q2 and Q3, we conducted chisquared analyses with the toddler group as reference group. Results: Late-identified LDs exist: There were new referrals in all age groups. Compared to older age groups, the toddler group contained fewer girls and multilingual children. The toddler group also contained fewer children without an LD and more children with LD + additional problems. Conclusions: Reassuringly, children with multiple language problems are referred earliest. However, late-identified LDs exist, even at high school age. Girls and multilingual children tend to be missed at younger ages. More work on awareness and identification of language delays is needed, requiring awareness, knowledge, and tools for educational professionals. [ABSTRACT FROM AUTHOR]

Purpose: Our aim was to develop consensus on the definition and operationalization of communicative participation (CP) in 2- to 8-year-old children with language disorders (LDs). A clear definition and operationalization can facilitate the discussion about children's communication problems in daily life between parents and professionals. Method: In an online Delphi study, anonymized thoughts and opinions were collected on the definition and operationalization of CP in young children with LD. The 47 Delphi panel members were Dutch parents, young adults with LDs, teachers and assistants, speech-language pathologists, clinical linguists, and clinical researchers. Thematic content analysis was used to develop a concept definition and items operationalizing CP. The Delphi panel rated the suitability of concept definitions using a 7-point Likert scale. Concept definitions were revised with feedback from the Delphi panel until consensus was achieved. The Delphi panel rated items on how well they operationalize CP, using the same Likert scale. Results: The majority (79%) of the Delphi panel indicated that the essence of CP was captured by the definition: "CP is understanding and being understood in a social context, by applying verbal and non-verbal communication skills." In addition, 33 behavioral items were developed. Conclusion: This study resulted in strong consensus on the definition of CP between Dutch parents and professionals. Items were developed that can inform speech-language pathologists on the type of questions to ask a child's parents or teacher when discussing CP. Further research is needed on how the items can best be used in clinical practice.

Purpose: Applying evidence-based grammar intervention can be challenging for speech and language therapists (SLTs). Language in Interaction Therapy (LIT) is a focused stimulation intervention for children with weak morphosyntactic skills, which was developed to support SLTs in incorporating results from effect studies in daily practice. The aims of this Clinical Focus are (a) to explain the principles and elements of LIT and stimulate use in daily SLT practice and (b) to describe the effects of LIT on morphosyntactic skills of 4- to 5-year-olds in special education, compared to usual care. Method: With a description of LIT, we provide guidance to implement evidence-based intervention. Important elements are as follows: proper selection of therapy goals, language facilitating techniques, child-centered and clinician-directed elements, and the use of scripts. Our focus in the description is on the support and practical solutions LIT tries to provide to SLTs. We also explored the implementation of LIT in special education, to improve morphosyntax in 4- and 5-year-old children. We provided SLTs with training and designed protocols for each therapy session. The effects of LIT were measured in a single-case A-B design, repeated in five children with developmental language disorders (ages 4;2-5;7 [years;months]). Conclusion: We conclude that implementation of LIT is possible if LIT is enriched with support in goal selection, protocols to guide therapy sessions, and training and coaching. In the single-case study, four children showed more growth in mean length of utterance during and directly following the LIT intervention phase, compared to the baseline phase with usual care, and in two of them, this difference was significant. The grammatical complexity measure "TARSP-P" showed an overall significantly higher score at group level during LIT, but limited effects on an individual level.

Background: Early detection and remediation of language disorders are important in helping children to establish appropriate communicative and social behaviour and acquire additional information about the world through the use of language. In the Netherlands, children with (a suspicion of) language disorders are referred to speech and hearing centres for multidisciplinary assessment. Reliable data are needed on the nature of language disorders, as well as the age and source of referral, and the effects of cultural and socioeconomic profiles of the population served in order to plan speech and language therapy service provision. Aims: To provide a detailed description of caseload characteristics of children referred with a possible language disorder by generating more understanding of factors that might influence early identification. Methods & Procedures: A database of 11,450 children was analysed consisting of data on children, aged 2-7 years (70% boys, 30% girls), visiting Dutch speech and hearing centres. The factors analysed were age of referral, ratio of boys to girls, mono- and bilingualism, nature of the language delay, and language profile of the children. Outcomes & Results: Results revealed an age bias in the referral of children with language disorders. On average, boys were referred 5 months earlier than girls, and monolingual children were referred 3 months earlier than bilingual children. In addition, bilingual children seemed to have more complex problems at referral than monolingual children. They more often had both a disorder in both receptive and expressive language, and a language disorder with additional (developmental) problems. Conclusions & Implications: This study revealed a bias in age of referral of young children with language disorders. The results implicate the need for objective language screening instruments and the need to increase the awareness of staff in primary child healthcare of red flags in language development of girls and multilingual children aiming at earlier identification of language disorders in these children.

Purpose: Our aim was to develop consensus on the definition and operationalization of communicative participation (CP) in 2- to 8-year-old children with language disorders (LDs). A clear definition and operationalization can facilitate the discussion about children's communication problems in daily life between parents and professionals. Method: In an online Delphi study, anonymized thoughts and opinions were collected on the definition and operationalization of CP in young children with LD. The 47 Delphi panel members were Dutch parents, young adults with LDs, teachers and assistants, speech-language pathologists, clinical linguists, and clinical researchers. Thematic content analysis was used to develop a concept definition and items operationalizing CP. The Delphi panel rated the suitability of concept definitions using a 7-point Likert scale. Concept definitions were revised with feedback from the Delphi panel until consensus was achieved. The Delphi panel rated items on how well they operationalize CP, using the same Likert scale. Results: The majority (79%) of the Delphi panel indicated that the essence of Cp was captured by the definition: 'CP is understanding and being understood in a social context, by applying verbal and non-verbal communication skills.' In addition, 33 behavioral items were developed. Conclusion: This study resulted in strong consensus on the definition of CP between Dutch parents and professionals. Items were developed that can inform speech-language pathologists on the type of questions to ask a child's parents or teacher when discussing CP. Further research is needed on how the items can best be used in clinical practice., Children with language disorder (LD) have difficulty understanding language and producing words or sentences. Signs and symptoms of LD vary across children, depending on the language domain(s) affected, the severity [...]

Purpose: Over the last 5 decades, many acoustic measures have been created to measure roughness and breathiness. The aim of this study is to present a meta-analysis of correlation coefficients (r) between auditory-perceptual judgment of roughness and breathiness and various acoustic measures in both sustained vowels and continuous speech. Method: Scientific literature reporting perceptual-acoustic correlations on roughness and breathiness were sought in 28 databases. Weighted average correlation coefficients (r[subscript w]) were calculated when multiple r-values were available for a specific acoustic marker. An r[subscript w] = 0.60 was the threshold for an acoustic measure to be considered acceptable. Results: From 103 studies of roughness and 107 studies of breathiness that were investigated, only 33 studies and 34 studies, respectively, met the inclusion criteria of the meta-analysis on sustained vowels. Eighty-six acoustic measures were identified for roughness and 85 acoustic measures for breathiness on sustained vowels, in which 43 and 39 measures, respectively, yielded multiple r-values. Finally, only 14 measures for roughness and 12 measures for breathiness produced r[subscript w] = 0.60. On continuous speech, 4 measures for roughness and 21 measures for breathiness were identified, yielding 3 and 6 measures, respectively, with multiple r-values in which only 1 and 2, respectively, had r[subscript w] = 0.60. Conclusion: This meta-analysis showed that only a few acoustic parameters were determined as the best estimators for roughness and breathiness.

Background: Atypical speech and language development is one of the most common developmental difficulties in young children. However, which clinical signs characterize atypical speech-language development at what age is not clear. Aim: To achieve a national and valid consensus on clinical signs and red flags (i.e. most urgent clinical signs) for atypical speech-language development in children from 1 to 6 years of age. Methods & Procedures: A two-round Delphi study in the Netherlands with a national expert panel (n = 24) of speech and language therapists was conducted. The panel members responded to web-based questionnaires addressing clinical signs. Consensus was defined as = 70% of the experts agreeing on an issue. Outcomes & Results: The first round resulted in a list of 161 characteristics of atypical speech and language development. The second round led to agreement on 124 clinical signs and 34 red flags. Conclusions & Implications: Dutch national consensus concerns 17-23 clinical signs per age year for the description of an atypical speech-language development in young children and three to 10 characteristics per age year being red flags for atypical speech-language development. This consensus contributes to early identification and diagnosis of children with atypical speech-language development, awareness and research.

Background: Collaboration between therapists and parents of children with developmental disabilities is a key element of family‐centred care. In practice, collaboration appears to be challenging for both parents and therapists. This systematic review aims to make explicit how therapists can optimise their collaboration with parents of young children with developmental disabilities, according to the perspectives of parents and therapists. Methods: A systematic review was conducted using the following databases: Medline (PubMed), CINAHL (OVID) and PsychINFO (OVID). Those papers were selected, which focused on collaboration using a two‐way interaction between therapists and parents, exploring the perspectives of therapists and/or parents of children between 2 and 6 years. Papers needed to be published in English or Dutch between 1998 and July 2021. Included papers were synthesised using a qualitative analysis approach by two researchers independently. Results sections were analysed line‐by‐line, and codes were formulated and discussed by all authors. Codes were aggregated, resulting in a synthesis of specific collaboration strategies in combined strategy clusters. Results: The search generated 3439 records. In total, 24 papers were selected. Data synthesis resulted in an overview of specific strategies organised into five clusters: (1) continuously invest time in your collaboration with parents, (2) be aware of your important role in the collaboration with parents, (3) tailor your approach, (4) get to know the family and (5) empower parents to become a collaborative partner. Conclusions: This systematic review resulted in an overview of concrete strategies for therapists to use in their collaboration with parents of children with developmental disabilities. The strategies formulated enable therapists to consciously decide how to optimise their collaboration with each individual parent. Making these strategies explicit facilitates change of practice from therapist‐led and child‐centred towards family‐centred care. [ABSTRACT FROM AUTHOR]

Background: Collaborative practice between therapists and parents is a key element of family‐centred care and is essential if we want to address family priorities and needs in interventions. However, collaborative practice is challenging for speech and language therapists (SLTs) and parents. To facilitate collaboration, collaborative practices need to be implemented into speech and language therapy for young children with developmental language disorders (DLD) and their families. Actual change and implementation of collaboration in practice will be successful only when it corresponds with patients' needs, in our case the needs of parents of young children with DLD. Aims: To explore parents' needs in their collaboration with SLTs during therapy for their young child with DLD. Methods & Procedures: Parents of children with (a risk of) DLD in the age of 2–6 years were eligible for participation. We recruited parents via SLTs. Twelve parents of children with DLD participated in semi‐structured interviews about their needs in collaboration with SLTs. We used a phenomenological approach focusing on parents' lived experiences. We transcribed the interviews verbatim. All interviews were read/listened to and discussed by our parent panel, multiple researchers and the interviewer. Two researchers independently analysed the data using the reflective thematic analysis of Braun and Clarke. Outcomes & Results: The analysis of the interviews resulted in six themes: (1) knowing what to expect, (2) knowing how to contribute, (3) feeling capable of supporting the child, (4) trusting the therapist, (5) alignment with parents and children's needs, preferences and priorities and (6) time and space for asking questions and sharing information. Conclusions & Implications: Parents want SLTs to invest time in collaborating with them. Parents need SLTs to empower them to become a collaborative partner and enable them to support their child in daily life. Parents need knowledge about the therapy process and diagnosis and skills in how to support their child's language development. Also, they need emotional support to feel secure enough to support their child, to ask questions to therapists and to bring up their own thoughts and opinions in therapy. Parents' needs are in line with collaborative working as described in literature, which underlines the importance of implementing collaborative working in speech and language therapy for young children with DLD. WHAT THIS PAPER ADDS: What is already known on the subject: Several reviews have explored parents' perspectives on speech and language therapy. Results reveal parents' experiences with speech and language therapy in general, and parents' perspectives on specific topics such as shared decision‐making and parents/therapists roles in therapy. What this study adds: This study adds insights into parents' needs to ensure collaboration with speech and language therapists (SLTs). Parents of young children with developmental language disorders (DLD) need SLTs to invest time to create optimal collaboration. It is important for parents to have enough knowledge about DLD and the SLT process, skills and confidence in how to support their child and opportunities to share thoughts and questions with SLTs. Our results underline the importance of parents being empowered by SLTs to become a collaborative partner. What are the clinical implications of this work?: When children are referred to speech and language therapy, parents often venture into an unknown journey. They need support from SLTs to become a collaborative partner in speech and language therapy. Parents need SLTs to invest time in sharing knowledge, skills and power and align therapy to parents' and child's needs, preferences, priorities and expectations. [ABSTRACT FROM AUTHOR]

Purpose: Over the last 5 decades, many acoustic measures have been created to measure roughness and breathiness. The aim of this study is to present a meta-analysis of correlation coefficients (r) between auditory-perceptual judgment of roughness and breathiness and various acoustic measures in both sustained vowels and continuous speech. Method: Scientific literature reporting perceptual-acoustic correlations on roughness and breathiness were sought in 28 databases. Weighted average correlation coefficients ([r.sub.w]) were calculated when multiple r-values were available for a specific acoustic marker. An [r.sub.w] [greater than or equal to] .60 was the threshold for an acoustic measure to be considered acceptable. Results: From 103 studies of roughness and 107 studies of breathiness that were investigated, only 33 studies and 34 studies, respectively, met the inclusion criteria of the meta-analysis on sustained vowels. Eighty-six acoustic measures were identified for roughness and 85 acoustic measures for breathiness on sustained vowels, in which 43 and 39 measures, respectively, yielded multiple r-values. Finally, only 14 measures for roughness and 12 measures for breathiness produced [r.sub.w] [greater than or equal to] .60. On continuous speech, 4 measures for roughness and 21 measures for breathiness were identified, yielding 3 and 6 measures, respectively, with multiple r-values in which only 1 and 2, respectively, had [r.sub.w] [greater than or equal to] .60. Conclusion: This meta-analysis showed that only a few acoustic parameters were determined as the best estimators for roughness and breathiness., Evaluation of voice quality and diagnosis of pathological phonation are main components of clinical assessment and research in laryngology and vocology. Two commonly observed voice quality subtypes include 'breathiness' and [...]