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Background: The risks of developmental language disorder (DLD) for both educational progress and socio-emotional development are well documented, but little is known about how children and young people with DLD experience and describe their language and communication. The need to complement experimental and quantitative studies with qualitative perspectives of the lived experience of individuals with DLD for speech and language therapists (SLT) practice has recently been foregrounded. Aims: To understand further the experiences of young people with DLD focusing on language and communication in a school context, and thereby contribute to the improvement of the communicative situation in school for this group. The study is guided by the following research question: How do young people diagnosed with DLD describe their experiences of language and communication in school? Methods & Procedures: The study is based on data generated from qualitative semi-structured interviews with 23 participants diagnosed with DLD (age 13-19 years old) living in Sweden. All participants attended mainstream schools. To enable data to be collected during COVID-19 restrictions, all interviews were conducted using Zoom. Reflexive thematic analysis was used to analyse the data. Outcomes & Results: Four main themes related to experiences of language and communication in school were constructed from the interviews: (1) feelings of inadequacy and comparisons with others; (2) feelings of being misjudged and misunderstood; (3) the importance of feeling safe and comfortable; and (4) the significance of the social and communicative context. The results bear witness of difficult and challenging aspects related to language and communication in school, including educational, social and emotional dimensions. An important outcome of this study is how young people diagnosed with DLD describe their language and communication functioning to be dependent on both individual characteristics and abilities, as well as situational, contextual and social factors. Conclusions & Implications: The results from this study show that young people with DLD can have persisting problems related to language and communication in school, including educational, social and emotional dimensions. SLT services may therefore be needed throughout the school years to ensure that students with DLD receive adequate support. In addition, support that goes beyond language abilities and targets social, contextual and emotional aspects should be considered.

Background: In dementia with Lewy bodies (DLB), limitations in linguistic and cognitive abilities may lead to difficulties in participating in conversations. The conversational outcome is also dependent on how the conversation partner adjusts to potential communicative challenges. Aims: This study explored resources and barriers in communication in DLB. Methods & Procedures: Linguistic and cognitive function was explored through standard clinical testing. The dyad's perception of function in daily life was explored through semi-structured interviews analysed with content analysis. Interactional patterns and participation in casual conversation was analysed with conversation analysis. Outcome & Results: The results show how the husband diagnosed with DLB performed with high scores across most cognitive and linguistic test tasks. The interview data, however, revealed how both he and his wife experienced significant challenges regarding, for example, conversational tempo, as well as negative feelings relating to adjusting to these conversational changes. The interactional data from the casual conversation revealed, among other patterns, how the wife engaged in most of the storytelling in the conversation. The husband contributed details when his wife asked for help, or he acknowledged a faulty or missing detail in his wife's storyline. Thus, they both oriented to the husband's competence in monitoring and keeping track of the conversational content, despite challenges in taking the floor. Conclusions & Implications: A holistic picture of communication in DLB necessitates the use of different evaluation approaches. Both monological (e.g., test tasks revealing cognitive and linguistic resources) and dialogical information sources (e.g., observations of conversations revealing adjustments in conversations), as well as the perceptions of those engaging in everyday conversations (i.e., people with DLB and their conversation partner(s)), need to be evaluated when assessing resources and barriers in communication.

Purpose: Speech-language pathologists (SLPs) are a new but rapidly growing addition to the Swedish school work force. This study sought to inventory the employment and work task characteristics of school-based SLPs to assess equitable access to SLP services. Method: We collected questionnaires from 111 SLPs currently practicing in Swedish schools. The respondents were asked for details regarding their employment. Results: Roughly equal proportions of respondents reported to work with intervention and consultation to teaching staff. Almost all reported that the preservice training provided insufficient preparation for school-based practices. The work assignments of school-based SLPs were more similar than 10 years ago, likely a consequence of agreements between the parties caring for students with language disorder, and the vast majority of SLPs now being employed within student health teams. However, differences in workload and assigned tasks affect the nature of the work performed, to the point that current best practice cannot always be upheld. Conclusions: The results indicate that the services provided by Swedish school-based SLPs can be expected to vary because of qualitative and quantitative differences in employment and work task characteristics. The results are discussed in light of reviews of language interventions for children and young people.

Recent studies have demonstrated that people living with dementia, contrary to common believes, are capable of novel learning without structured interventions. Opportunities for learning throughout an individual's lifespan have been acknowledged as important factors in facilitating social participation and promoting wellbeing. However, little is still known about the situated practices used in the learning process for people living with dementia. This study aims to explore how people living with dementia in Swedish residential care facilities position, perceive, and assert, themselves as learners in a novel activity. The study is based on video recordings of eight people living with dementia, who for the first time use tablet computers as a social activity on a one-to-one basis with their formal caregivers. Through interaction analysis, we show how the participants living with dementia use the engagement displays of "requests," "accounts," "formulations" and "metacomments" to make their active undertaking in the ongoing activity public to their communication partner. Our findings suggest that people living with dementia might still perceive themselves as individuals capable of novel learning and that they are active and engaged agents in this process.

Children with hearing impairment (HI) are at an increased risk of developing speech and language problems similar to those of children with developmental language disorder (DLD), including difficulties with phonology and grammar. This study investigated similarities and differences in phonological and grammatical production between children with bilateral sensorineural HI (n = 14) and children with DLD (n = 30) between 4-6 years of age and age-matched controls with typical language development and normal hearing (TLD) (n = 29), all with Swedish as their first language. Production of consonants, vowels, stress patterns and tonal word accents was assessed in a picture naming task, and in a word and nonword repetition task. Grammatical production was assessed for verb and noun morphology, and syntax. While performance for both children with HI and DLD were generally significantly below that of the controls with TLD, production of accents and syntax emerged as relative strengths. There were few differences between the between the children with HI and DLD, but noun-adjective agreement in predicative was more challenging for the children with HI. The results have implications for language assessment and planning of intervention.

Models of speech and language intervention for communicative disabilities vary from structured programmes to more interactive and ecological methods (Fey, 1986). Ideally, a model for intervention should fit the interests and personality of the patient, focus on crucial aspects of speech and language, and be suited to the patient's everyday communication needs (Johnston, 2006). The present article addresses how features of everyday interaction and speech and language intervention may be captured and used for children with language impairment (LI), their caretakers, and speech and language therapists (SLTs), within and outside of clinical practice. Specifically, the aim of the study is to explore the use of retrospection (Erickson and Schultz, 1982), based on Conversation Analytical (CA) methodology (e.g. Schegloff, 2007), and to establish if and how CA-based retrospection may contribute to raising participants' awareness of their own and others' interactional behaviours. Retrospection here refers to sessions where participants watch and comment on sequences of video-recordings from intervention, as well as from situations captured in a variety of everyday settings. Four children with LI and three speech and language therapists participated, as well as parents of the children. The procedure comprised analysis and transcription of video-recordings of everyday interaction and intervention involving the children, retrospections with the children, the parents of the children with LI, and the SLTs, and analysis and transcription of the recordings made of the retrospections. The analysis of the retrospections generated four categories of phenomena relevant for intervention and everyday interaction: (1) Observations of well-functioning interaction strategies; (2) Observations of less well-functioning interaction strategies; (3) Assessment of positive performance; and (4) Comments relating to intervention. The results show that CA-based retrospection may be used to raise the participants' awareness of their own interactional behaviours, and provide the opportunity to discuss strategies relevant for both intervention and everyday interaction for children with LI.

In this study, segmental and prosodic aspects of word repetition and non-word repetition in typically developing children aged four to six years were investigated. Focus was on developmental differences, and on how tonal word accent and word length affect segment production accuracy. Prosodically controlled words and non-words were repeated by 44 Swedish-speaking children. Repetition accuracy for both words and non-words increased with age, and was higher for words than non-words. Further, tonal word accents I and II provided different conditions for segment repetition in favor of accent II during both word repetition and non-word repetition for older children, but only during word repetition for younger children. This suggests age-dependent differences regarding how prosody is stored and integrated with segments. The findings have theoretical significance regarding the role of prosody in the perception, processing and production of phonological information. There are also clinical implications concerning the interpretation of repetition tasks and the potential use of prosody in speech and language intervention.

Imprecise consonant articulation is common in speakers with Parkinson's disease and can affect intelligibility. The research on the relationship between acoustic speech measures and intelligibility in Parkinson's disease is limited, and most of the research has been conducted on English. This pilot study investigated aspects of consonant articulation acoustics in eleven Swedish speakers with Parkinson's disease and six neurologically healthy persons. The focus of the study was on consonant cluster production, articulatory motion rate and variation, and voice onset time, and how these acoustic features correlate with speech intelligibility. Among the measures in the present study, typicality ratings of heterorganic consonant clusters /spr/ and /skr/ had the strongest correlations with intelligibility. Measures based on syllable repetition, such as repetition rate and voice onset time, showed varying results with weak to moderate correlations with intelligibility. One conclusion is that some acoustic measures may be more sensitive than others to the impact of the underlying sensory-motor impairment and dysarthria on speech production and intelligibility in speakers with Parkinson's disease. Some aspects of articulation appear to be equally demanding in terms of acoustic realisation for elderly healthy speakers and for speakers with Parkinson's disease, such as sequential motion rate measures. Clinically, this would imply that for the purpose of detecting signs of disordered speech motor control, choosing measures with less variation among older speakers without articulation impairment would lead to more robust results. [ABSTRACT FROM AUTHOR]

Dementia is a source of growing concern globally, and often impacts on social and communicative functioning. INdependent LIving Support Functions for the Elderly (IN LIFE) was a project carried out within the European Commission Research and Innovation programme Horizon 2020 that resulted in the development of two digital communication aids for reminiscence intervention for elderly people with dementia and their communication partners. The purpose of this intervention study was to investigate the effects on quality of life for people with dementia when using these aids. People with dementia (N = 118) and their formal care-givers (N = 187) and relatives (N = 9) were given the communication aids for a period of 4–12 weeks. To assess a range of outcomes, questionnaires developed within the project were used along with the EQ-5D (European Quality of Life – 5 Dimensions) and QoL-AD (Quality of Life in Alzheimer's Disease) questionnaires. Quality of life improved among people with dementia when measured using EQ-5D (p < 0.05). There was also a correlation between the impact on the participants' health and wellbeing, the carers' rating of the usefulness of the digital communication aids and the care-givers' satisfaction with using technology (p < 0.05). These results indicate that digital communication aids may be useful in social interaction where one partner has dementia. [ABSTRACT FROM AUTHOR]

According to the Simple View of Reading, reading ability can be divided into decoding and language comprehension. In the present study, decoding and comprehension's contribution to reading ability was studied both in children with reading difficulties and in children with typical reading ability. Decoding and comprehension was further divided into sub-components, and the contribution from non-verbal ability and general processing speed was also studied. The results demonstrated that decoding made the largest contribution to reading ability for children with reading difficulties, while language comprehension contributed the most for children with typical reading ability. The contribution of non-verbal ability was not significant, and general processing speed only made a significant contribution to decoding for typical children. The two factors in the Simple View of Reading, decoding and comprehension, together explained less of the variance in reading ability for children with reading difficulties than for children with typical reading ability. (Contains 2 tables and 2 figures.)

Purpose: In primary progressive aphasia (PPA), multimodal means may gradually become more important in conversations. In this study, the aim was to investigate the functions of hand movements of a man with PPA. Method: Peter and Karen participated in this study. Peter was diagnosed with nonfluent PPA two years prior to data collection. Casual conversation and cognitive and linguistic testing were audio- and video-recorded. Analyses were informed by multimodal interaction analytical approaches. Results: The results showed that Peter's opportunities to engage in conversations were enabled within a co-operative framework, where Peter would contribute within a predetermined slot using a variety of multimodal resources to, for example, organize turn-taking or repair difficulties relating to verbal output. Discussion and conclusions: Studying multimodal resources across tasks may reveal important features of the ways in which persons with communicative impairment adjust to different contexts. In clinical settings, multimodal resources need to be viewed as multi-layered actions rather than as isolated contributions. [ABSTRACT FROM AUTHOR]

Swedish has a complicated prosodic system, compared, for example, with English. A large proportion of Swedish children with language impairment (LI) have prosodic problems to some extent. There are few descriptions in the literature of prosody intervention, which means that clinicians must rely on their overall linguistic and therapeutic knowledge when designing intervention for prosodic problems. The aim of the present study is to design an intervention package for prosodic problems in children and to evaluate this intervention. The article reports a single subject multiple baselines case study. The participant was a boy (aged 4 years and 6 months) with prosodic problems, mainly on word level but also on phrase and discourse level. The intervention was devised to address his problems and focused on word level prosody. The intervention was carried out over 6 weeks, comprising six 60-minute sessions. Post-intervention assessments were carried out immediately after intervention and 9 weeks later. The participant improved his overall prosodic skills significantly, as assessed by a procedure designed to capture prosody at word, phrase and discourse level. An evaluation of a spontaneous speech sample was also made by a panel of three experienced listeners, and they found some improvement in the participant's prosody in connected speech, although this was not significant. (Contains 1 table and 2 figures.)

Prosody carries a lot of information relevant for our understanding of spoken messages. In addition, prosody plays an important role in signalling attitudes and emotions. Prosodic features also constitute an important resource that participants use to achieve mutual understanding in interaction. The aim of this study was to point to possible recurring patterns in the prosodic structure of language testing activities. A further aim was to discuss similarities between English and Swedish in these patterns. The main findings indicated a systematic use of prosody in the language testing activity. Questions are mainly posed with rising intonation and answers are produced with rising intonation. Evaluations are produced with a final fall in the intonation. There was also some support for the assumption that this pattern occurs within a similar activity involving an English-speaking child and his SLT. The results of the present study showed that analysis of conversation and prosody in its conversational context is useful in order to reveal possible functions of features that would have been overlooked with a more deficit driven perspective. (Contains 2 tables.)

The present study was designed to examine the production of the Swedish tonal accents in children with language impairment and normal controls in order to verify previous findings. The productions of 25 children with linguistic impairment and their matched controls, aged 4; 4-10; 0 (mean age 5;11) were evaluated by ratings of fundamental frequency patterns, and by perceptual analysis by ten linguistically naive listeners to assess the distinctiveness of the accents. These methods give a more detailed description of the children's productions of tonal word accents. The results show that 60.8% of the children with language impairment have difficulties to produce the contrast of tonal word accents according to the F[subscript 0 patterns. The difference in the rating of the F[subscript 0] curves between the children with LI and their matched controls was significant. There is a significant positive correlation between the perceptual results and the F[subscript 0]-rating, indicating that the better a child was perceived, the better his/her F[subscript 0] production was rated. We conclude that the distinction between the tonal word accents is a difficult feature to acquire for Swedish children, which is shown both by acoustic and perceptual evaluations. (Contains 3 tables and 6 figures.)

A previous study has shown that Swedish children with language impairment have prosodic problems at different levels of language. The aim of this study is to investigate prosodic problems at the discourse level in two of the children to see whether they are related to pragmatic problems. Prosodic and pragmatic abilities were assessed by perceptual and acoustic evaluations. The children's communication checklist (CCC) was used to evaluate the children's pragmatic abilities and analysis of spontaneous speech samples was made. The results of the perceptual evaluations showed that the children have prosodic problems at the discourse level. The acoustic analysis also provided some support of this result. According to the CCC and the analysis of spontaneous speech samples the children had pragmatic problems. The results support the assumption that the prosodic problems at the discourse level are related to the pragmatic problems and indicate that the prosodic problems might be secondary to the pragmatic problems. However, far-reaching generalizations can not be made from this case study of two children.

Background: In dementia with Lewy bodies (DLB), limitations in linguistic and cognitive abilities may lead to difficulties in participating in conversations. The conversational outcome is also dependent on how the conversation partner adjusts to potential communicative challenges. Aims: This study explored resources and barriers in communication in DLB. Methods & Procedures: Linguistic and cognitive function was explored through standard clinical testing. The dyad's perception of function in daily life was explored through semi‐structured interviews analysed with content analysis. Interactional patterns and participation in casual conversation was analysed with conversation analysis. Outcome & Results: The results show how the husband diagnosed with DLB performed with high scores across most cognitive and linguistic test tasks. The interview data, however, revealed how both he and his wife experienced significant challenges regarding, for example, conversational tempo, as well as negative feelings relating to adjusting to these conversational changes. The interactional data from the casual conversation revealed, among other patterns, how the wife engaged in most of the storytelling in the conversation. The husband contributed details when his wife asked for help, or he acknowledged a faulty or missing detail in his wife's storyline. Thus, they both oriented to the husband's competence in monitoring and keeping track of the conversational content, despite challenges in taking the floor. Conclusions & Implications: A holistic picture of communication in DLB necessitates the use of different evaluation approaches. Both monological (e.g., test tasks revealing cognitive and linguistic resources) and dialogical information sources (e.g., observations of conversations revealing adjustments in conversations), as well as the perceptions of those engaging in everyday conversations (i.e., people with DLB and their conversation partner(s)), need to be evaluated when assessing resources and barriers in communication. What this paper adds: What is already known on the subject: It is well‐known that dementia with Lewy bodies (DLB) affects language and cognition. In conversations, persons with DLB experience difficulties in turn‐taking, topic initiation, entering conversations and keeping up with the conversational tempo. What this study adds: This study sheds light on conversations in one dyad where the husband has been diagnosed with DLB. The results from three different information sources (testing of language and cognition, interviews and a video‐recorded conversation) reveal patterns of resources and barriers that at first appear to contradict each other. However, the contradictions can be resolved when these discrepancies are examined in light of the differences in task structure, in terms of, for example, predetermined topics and how turn‐taking is managed. What are the potential or actual clinical implications of this work?: In order to gather a holistic picture of a person's conversational abilities, clinicians need to include information from both monological tasks (e.g., linguistic testing) as well as dialogical tasks (e.g., video recordings from conversation). The results also need to be evaluated in light of all conversation partners' perspectives on function in daily life. Furthermore, it is important to consider the nature of assessment tasks (particularly their interactional structure) when interpreting assessment results. [ABSTRACT FROM AUTHOR]

Background: Symptoms of prosodic problems have been found in Swedish children with language impairment at word and phrase level and possibly also at discourse level. Aims: The aim was twofold. First, to characterize a group of children with prosodic problems compared with children with normal language development. Second, to investigate the possibilities to classify subgroups of prosodic problems. Methods & Procedures: A new Swedish assessment procedure for prosody that captures prosodic features at word, phrase and discourse level was used. Twenty-five children with prosodic problems and 25 children with typically developing language matched by age, gender and regional dialect participated in the study. Pretesting included tests of language comprehension, grammatical skills and oral motor skills. Outcomes & Results: The difference between the experimental and control groups was highly significant in all parts of the procedure. The total score of the procedure significantly correlated with grammatical abilities measured in the pretesting procedure, but there was no correlation with the other linguistic abilities measured in the pretesting procedure. Conclusions: The results indicate a possible differentiation into two different subgroups, one with primarily phonetic and/or linguistic problems, the other with prosodic problems at discourse level possibly related to pragmatic problems.

Language problems in dementia resemble the symptoms of aphasia in many respects. Persons with aphasia (PWA) and persons with dementia (PWD) present rather similar results on standardised language tests and cognitive screening tools. There is limited research that compares PWA's and PWD's language abilities, and a particularly small number of studies have an interactional focus. In this study, we will contribute to the emergent discussion about interaction in aphasia and dementia. The aim was to investigate instances of trouble in conversations involving PWD, PWA and speech and language pathologists (SLPs), with a particular focus on trouble domain and interactional consequences. Ten PWD and 10 PWA were video-recorded during informal conversations with SLPs. Ten minutes of each conversation were transcribed thoroughly according to Conversation Analytical principles and instances of trouble were identified and calculated throughout the data. Thereafter, the instances of trouble were categorised by trouble domain: as connected to either primarily linguistic or cognitive issues. At first glance, the conversations between the PWD and PWA seemed rather similar when looking at the number of turns and the number of instances of trouble. The analyses, however, reveal that significantly more turns were spent on trouble solving in the conversations involving the PWA. The vast majority of the troubles involving the PWA were categorised as being connected primarily to linguistic issues, whereas trouble among the PWD were more evenly distributed between the trouble domains. The SLPs took a more active role in supporting the conversations of the PWA than for the PWD. The results indicate that many conversational troubles involving PWD are connected to primarily linguistic issues. However, PWD seem to have less severe linguistic problems compared to PWA. The analyses also reveal that many of the language problems described in PWD might be a direct consequence of cognitive issues, and that SLPs may take a more passive role in trouble solving in conversations involving PWD. The lack of personal common ground and preconceived notions about the medical conditions are discussed as potential motives for the SLPs' behaviour. The analysis of instances of trouble in informal conversations might contribute to both research and clinical assessment of language abilities in PWA and PWD. [ABSTRACT FROM AUTHOR]

This study challenges the notion that people living with dementia are unable to achieve novel learning without focussed intervention techniques. The purpose of this study is to explore how a woman living with dementia (Alzheimer's disease) learns to use a tablet computer with support from communicative partners. The study is based on video recordings and the theoretical framework of learning as changing participation in joint activities. Quantitative and qualitative focus is on changes in the interactional organization over the course of six weeks in the activity of using an augmentative and alternative communication application. Over time, the participant living with dementia, relies less on the expertise and explicit instructions of her communicative partners when navigating the application, and more on the immediate feedback provided by the tablet computer. The findings suggest that novel learning still is possible for people living with dementia, even without the implementation of focussed interventions. This study further emphasizes the procedural nature of learning for people living with dementia as the woman's embodied actions were carried out in an increasingly more direct fashion. For people living with dementia, learning in everyday activities is facilitated by repeated exposure to the activity and the scaffolding practices of a more experienced communicative partner. In instances of novel learning, one should not underestimate the importance of embodied engagement from people living dementia. Care professionals need not to worry about exposing people living with dementia to unfamiliar activities. [ABSTRACT FROM AUTHOR]

Objectives: This study investigated Swedish clinical professionals' experiences of diagnostic pathways in dementia, focusing on the assessment of cognitive and communicative abilities. Methods: Interdisciplinary teams in Memory Clinics, General Practitioners in Primary Health Care, and Speech Language Pathologists were interviewed. The transcripts were analyzed using qualitative Content Analysis. Results: The study sheds light upon the perceived barriers and facilitators of good practice, e.g. time and clinical collaborations. Perspectives among professionals vary as to how informal and formal information and procedures are to be integrated and weighted. External factors (e.g. physical proximity of professions) have considerable influence on information availability, transmission, and diagnostic processes. Communication impairment does not emerge as a clinical priority. Conclusions: Published clinical guidelines notwithstanding, there is in practice no "gold standard" regarding diagnostic processes. Reorganization of services that impact feasibility of cross-disciplinary contact may negatively impact diagnostics. Clinical implications: Interprofessional collaboration is impacted by many factors, e.g. physical proximity and availability of specific professions. In order to optimize collaboration in dementia diagnosis, communication channels between professions need to be optimized. Additionally, making clinical impressions and "gut-feelings" explicit could contribute valuable information to the diagnostic process. [ABSTRACT FROM AUTHOR]