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Purpose: Listening to children using age-appropriate techniques supports evidence-based clinical decision-making. In this article, we test the Sound Effects Study Drawing Protocol, an arts-based technique, to support children with speech sound disorder (SSD) to express their views about talking. Method: Participants were 124 Australian children aged 4–5 years in the Sound Effects Study. Their parents and teachers were concerned about their talking, and they were assessed as having SSD on the Diagnostic Evaluation of Articulation and Phonology. Drawings and children's interpretations were elicited then analyzed using the (a) Who Am I? Draw-a-Person Scale and (b) Sound Effects Study Focal Points. Results: Drawings were developmentally typical for 4- to 5-year-olds. The six Sound Effects Study Focal Points were identified across the 124 drawings: body parts and facial expressions, talking and listening, relationships and connection, positivity, negativity, and no talking. Participants portrayed talking and listening as an action requiring mouths and ears represented by symbols (letters, speech bubbles) or as an activity with a variety of people. Children typically portrayed themselves as happy when talking; however, some portrayed negativity and some chose not to draw talking. Conclusions: In keeping with Articles 12 and 13 of the Convention on the Rights of the Child, this research demonstrated that 4- to 5-year-old children with SSD can express their views about talking via drawing. Professionals may use the Sound Effects Study Drawing Protocol as a child-friendly technique to support children to express views to guide holistic, evidence-based, child-centered speech-language pathology practice.

Speech-language pathologists (SLPs) face challenges in transcription and diagnosis of speech sound disorders (SSD) in multilingual children due to ambient language influences and cross-linguistic transfer. The VietSpeech Multilingual Transcription Protocol, a 4-step process to undertake impressionistic transcription of multilingual speech was tested using data from Vietnamese-Australian children (

For speech-language pathologists (SLPs) working with multilingual children, differential diagnosis between typical development and speech sound disorder may be complex. This paper presents a longitudinal case study of a bilingual Vietnamese–Australian child (PE) between the ages of 3 years;10 months (3;10) and 6;10, to explore the impact of cross-linguistic transfer and ambient phonology on speech acquisition. PE completed speech assessments as a participant in the VietSpeech Study: the Vietnamese Speech Assessment and the Diagnostic Evaluation of Articulation and Phonology in English. Differential diagnosis based on English speech assessment alone indicated speech sound disorder; yet differential diagnosis based on speech assessment in both languages revealed developmental, cross-linguistic transfer, and ambient phonological influences to be the primary reasons for mismatches. Independent and relational analyses at 3;10 revealed age-appropriate phonetic inventories in Vietnamese and English and bi-directional cross-linguistic transfer: segmental transfer of non-shared consonants, non-shared phonological patterns, and a preference for palatal and retroflex consonants. Contrastive analysis with family members demonstrated the impact of ambient phonology on PE’s speech. Over the three years her speech accuracy improved and mismatches reduced. By 6;10 her English speech was age appropriate and some cross-linguistic transfer was still evident in Vietnamese. Evidence is presented for how dual phonological systems can interact over time until they stabilize. During differential diagnosis, SLPs need to consider the influence of cross-linguistic transfer and ambient phonology on bilingual speech acquisition.

Parent-child book reading with infants is widely recommended and considered one of the most effective parent-child activities for promoting language and literacy development; however, there is limited evidence that reading books with infants (1–2 years) strengthens later literacy skills. The present study examined the long-term impact of parent-child book reading at 1–2 years with literacy, language, and numeracy skills at 8–11 years. Participants were 3547 infants and their caregivers from a nationally representative study. The number of minutes caregivers reported reading books with their infants (1–2 year) were examined with literacy, language, and numeracy skills on a national assessment program in Grades 3 (8–9 years) and 5 (10–11 years). Covariates included sex, age, race, language background, socioeconomic position, and cognition. Small and positive relationships were found between parent-child book reading at 1–2 years and reading, spelling, grammar, and numeracy scores in Grade 3 (8–9 years) and reading, writing, spelling, and grammar scores in Grade 5 (10–11 years). Infants (1–2 years) whose parents read with them for 11 minutes or more per day had stronger reading, spelling, and grammar skills in Grades 3 and 5.

This study aimed to investigate reported family language policies (quy tắc sử dụng ngôn ngữ cho gia đình) and language maintenance practices among Vietnamese–Australian parents. This mixed-methods study collected 151 Vietnamese–Australian parents' responses to close- and open-ended questions within an online questionnaire that was available both in English and Vietnamese. Bivariate analyses and logistic regression were conducted to explore associations between family language policies and factors related to demographics and Spolsky's language policy theory. Content analysis was undertaken in NVivo to investigate family language policies. One-third of the participants (35.6%) reported to have a family language policy and 72.5% of those with a policy indicated that they consistently implemented their policy. Significant factors associated with having a family language policy were parents' higher Vietnamese proficiency, more Vietnamese language use with their children, and intention of future residence in Vietnam. The four identified language policies were as follows: (1) using Vietnamese with the nuclear family (FLP1), (2) Vietnamese outside the nuclear family (FLP2), (3) English at home (FLP3), and (4) English outside the home (FLP4). Some families used more than one of these concurrently. This is one of the first large-scale mixed-method studies to explore family language policies, and the first to explore this issue with Vietnamese-speaking families in Australia. Many Vietnamese–Australian families do not explicitly have a family language policy aimed at maintaining Vietnamese at home; therefore, the Vietnamese–Australian community is at risk of a shift toward English language dominance and home language loss. As a result, the benefits of multilingualism within the Vietnamese–Australian community may be lost without support from the government and community to maintain their home language.

BACKGROUND: Waiting lists for speech and language therapy exist when services do not meet demand. Waiting lists pose practical and ethical challenges for speech and language therapists (SLTs) and workplaces to manage, with potential flow on effects for children and families. OBJECTIVE: The present study aimed to describe SLTs’ perspectives about waiting lists for children with speech, language, and communication needs (SLCN) and explore waiting list management strategies. METHODS: The present study reports on 187 SLTs’ written responses to open-ended questions in a questionnaire. SLTs were from nine countries, had an average of 12 years’ experience in the profession (range 0.2–45 years), and either currently or had previously worked with children. Data were analysed qualitatively using thematic analysis. RESULTS: SLTs’ feelings about their waiting lists centred on three themes: (1) negative (e.g., “overwhelmed”, “stressed”, “anxious”, “embarrassed”); (2) neutral (e.g., “not too bad”, “okay”); and (3) positive (e.g., “manageable”, “proud”). Four themes related to waiting list management: (1) SLT service delivery (e.g., triage, use of technology in service provision); (2) workplace processes and policies (e.g., eligibility criteria, prioritisation); (3) SLT workforce (e.g., recruitment and retention of skilled SLTs); and (4) inaction (e.g., waiting list management was “out of my hands”). CONCLUSIONS: Waiting lists can have negative consequences and many SLTs take action to manage waiting lists; however, waiting list management strategies are not necessarily effective which can impact children’s outcomes. There is a need to reimagine service delivery and identify effective actions for managing speech and language therapy waiting lists at a local and systemic level in order to optimise outcomes for children and families.

Speech intelligibility describes the degree of understanding messages between speakers and listeners. Speech intelligibility plays an important role in examining children’ speech, in diagnosing speech sound disorders, in setting goals, planning intervention, and evaluating effectiveness of speech interventions. The Intelligibility in Context Scale (ICS) is one of the most popular speech intelligibility measurement tools and has been translated into more than 60 languages across the world. This paper presents a scoping review of 39 publications including five describing, 19 norming and validation studies and 15 studies reporting on the use of ICS. Based on content analysis, this paper describes the development and translation, norming, validation and use of the ICS with children speaking English (five descriptions and nine papers), children speaking 14 other languages across the world (21 papers), and children speaking Vietnamese in Vietnam (four papers). Participants in the ICS studies were: monolingual, bilingual and multilingual; with and without speech sound disorders; and from 1-2 years old to adults but mainly in the preschool age range. The ICS’s mean scores, internal reliability, internal consistency, sensitivity, specificity as well as other psychometric properties were reported in ICS studies. These indicators reveal evidence that ICS is a reliable scale to use in research and clinical practice to measure speech intelligibility of children speaking different languages across the world including children speaking northern and southern Vietnamese dialects.

Speech sound disorders (SSD) is a common communication disorder with long-term consequences in children. Diagnosis and assessment play an important role in the identification of SSD and its severity, to assist goal setting and intervention planning and to measure progression. In order to define and describe diagnostic criteria regarding SSD in children, this review paper uses content analysis of 14 studies reporting on children with SSD. Results reveal that diagnostic criteria for SSD in children include: 1) Mean scores of percentage phonemes correct (e.g., percentage of consonants correct, PCC, and percentage of vowels correct, PVC); 2) phonological processes; 3) “concern” from parents, teachers, and children themselves about children’s speech and pronunciation; and 4) children's speech intelligibility. While mean scores of the percentage of consonants correct were varied between studies, diagnostic criteria for identifying SSD were achieving a PCC score between one and two standard deviations below the mean for the child’s age. Some children with SSD were reported to use phonological processes that are occasional (>10%) and rare (>5%), or are still being used at an older age compared to typically developing children. Many children with SSD had parents and teachers who were concerned about their speech and pronunciation. Mean scores of young children’s speech intelligibility measured by the Intelligibility in Context Scale were typically below 4.0. This review provides useful information and a foundation for research and clinical practice in a language in which diagnosis criteria for SSD have not been established.

Aim: To explore Vietnamese–Australian children’s proficiency and use of Vietnamese and English and identify associated factors that are related to demographics, language practices, language ideologies, and language management. Methodology: Vietnamese–Australian parents ( n = 151) completed a questionnaire (in English or Vietnamese) regarding their child’s language proficiency and use, demographic details and a range of factors as conceptualized by Spolsky’s language policy theory: language practices; language ideologies; and language management. Data and analysis: Bivariate analyses (Pearson’s correlation and analysis of variance) and multiple regression models were conducted to explore associations between language proficiency and use and associated factors and identify the most significant factors. Findings/conclusions: Factors associated with children’s Vietnamese language proficiency (oral/written) included: demographic factors; language practices; language ideologies; and language management. In contrast, children’s English language proficiency (oral/written) was linked to demographic factors and language practices. Children’s Vietnamese language use was not significantly correlated with demographics but rather with language practices, language ideologies, and language management. Children’s home language use and proficiency did not have a negative impact upon their English proficiency. Originality: This study is the first to consider factors associated with Vietnamese–Australian children’s language proficiency and use. Significance/implications: Demographic factors, language practices, language ideologies, and language management were associated with children’s language proficiency and use. The results can be used by parents, educators, policy-makers, speech–language pathologists and other professionals to support Vietnamese–Australian and multilingual children around the world to develop and maintain their home and majority languages.

The aim of this study is to identify factors associated with Vietnamese-Australian parents’ language use and attitudes towards home language maintenance. Vietnamese-Australian parents (n = 151) wit...

Understanding typically developing children’s speech acquisition is useful to assist speech-language pathologists’ diagnosis and intervention planning for children with speech sound disorders. The ...

The majority of children acquire language effortlessly but approximately 10% of all children find it difficult especially in the early or preschool years with consequences for many aspects of their subsequent development and experience: literacy, social skills, educational qualifications, mental health and employment. With contributions from an international team of researchers, this book is the first to draw together a series of new analyses of data related to children's language development, primarily from large-scale nationally representative population studies, and to bring a public health perspective to the field. The book begins with a section on factors influencing the patterns of language development. A second section explores continuity and change in language development over time. The third explores the impact on individuals with developmental language disorders (DLD), the effectiveness of available interventions, and broader issues about the need for equity in the delivery of services to those with DLD.

Purpose Speech-language pathologists' clinical decision making and consideration of eligibility for services rely on quality evidence, including information about consonant acquisition (developmental norms). The purpose of this review article is to describe the typical age and pattern of acquisition of English consonants by children in the United States. Method Data were identified from published journal articles and assessments reporting English consonant acquisition by typically developing children living in the United States. Sources were identified through searching 11 electronic databases, review articles, the Buros database, and contacting experts. Data describing studies, participants, methodology, and age of consonant acquisition were extracted. Results Fifteen studies (six articles and nine assessments) were included, reporting consonant acquisition of 18,907 children acquiring English in the United States. These cross-sectional studies primarily used single-word elicitation. Most consonants were acquired by 5;0 (years;months). The consonants /b, n, m, p, h, w, d/ were acquired by 2;0–2;11; /ɡ, k, f, t, ŋ, j/ were acquired by 3;0–3;11; /v, ʤ, s, ʧ, l, ʃ, z/ were acquired by 4;0–4;11; /ɹ, ð, ʒ/ were acquired by 5;0–5;11; and /θ/ was acquired by 6;0–6;11 (ordered by mean age of acquisition, 90% criterion). Variation was evident across studies resulting from different assessments, criteria, and cohorts of children. Conclusions These findings echo the cross-linguistic findings of McLeod and Crowe (2018) across 27 languages that children had acquired most consonants by 5;0. On average, all plosives, nasals, and glides were acquired by 3;11; all affricates were acquired by 4;11; all liquids were acquired by 5;11; and all fricatives were acquired by 6;11 (90% criterion). As speech-language pathologists apply this information to clinical decision making and eligibility decisions, synthesis of knowledge from multiple sources is recommended.

Introduction: High demand for speech-language pathology means children sometimes wait over 12 months for services, missing out on timely support. Waiting can be a time of stress, concern, and powerlessness for caregivers. Provision of information via a website may support families and encourage active waiting. Objective: The aim of this study was to compare children’s speech, intelligibility, language, and literacy outcomes, and caregivers’ satisfaction and empowerment in active versus passive waiting conditions. Methods: Ninety-seven preschool-aged children referred to a community health speech-language pathology service in Australia were screened for eligibility. Eligible children (n =42) with speech/language difficulties were randomly allocated to: (a) active waiting (provision of a purpose-built website; n = 20), or (b) passive waiting (control group; n = 22). Pre- and post-assessments (after 6 months on a waiting list) were completed with children and caregivers by a speech-language pathologist blinded to group allocations. Results: Intention to treat (n =36) and per-protocol analyses (n =30) were conducted to measure group differences in child and caregiver outcomes at post-assessment using one-way ANCOVA, controlling for baseline scores. There were no statistically significant differences between groups for children’s speech, intelligibility, language, and literacy, or caregivers’ empowerment and satisfaction. Children in both groups made minimal gains over 6 months. Conclusions: Provision of an active waiting website did not lead to statistically significant change in child or caregiver outcomes, and children in both groups made little progress over a 6-month period. Early speech-language pathology intervention delivered with appropriate dosage is needed to optimise children’s outcomes. Until timely and effective speech-language pathology intervention can be provided for all who need it, provision of early assessments may be beneficial. There remains a need for effective ways to support children and families on waiting lists.

Objective: To evaluate how the practice of specialist speech-language pathologists (SLPs) working with young children with cleft palate ± cleft lip (CP±L) maps onto the International Classification of Functioning, Disability, and Health – Children and Youth version (ICF-CY) and consider the functionality of the categories of the ICF-CY for this specialist area of practice. Design: Cross-sectional, qualitative study. Setting: Semistructured face-to-face interviews were conducted with SLPs working in tertiary-level hospitals, universities, and public clinics. Participants: Six specialist SLPs with 17 to 39 years of experience working with young children with CP±L as researchers and clinicians in Australia, Brazil, Denmark, Ireland, New Zealand, and the United States. Main Outcome Measure(s): Specialists’ practices were captured using in-depth, semistructured interviews. Data collected were analyzed by directed content analysis applying the ICF-CY as a coding schema. Results: In total, 4077 data points were coded. Most mapped onto Body Structures (684, 16.8%), Body Functions (906, 22.2%), and Environmental Factors (1626, 39.9%) with less emphasis on Activities and Participation (560, 13.7%). A “best fit” approach was taken to topics that did not map exactly onto categories of the ICF-CY (eg, velopharyngeal insufficiency [VPI]); however, there was not always an ideally suitable category available. Conclusions: The current study revealed strengths and challenges in categorizing practice within the ICF-CY for children with CP±L, including collaboration with parents and significant others, specificity around speech, language, and articulation, and the different types of VPI. Therefore, future discussion around how best to use the framework with children with CP±L is needed.

Purpose: High demand for speech-language pathology services is reflected in long waiting lists. Waiting can be active or passive and has implications for stakeholders, including consumers, professi...

Purpose: The speech of some children does not follow a typical normalization trajectory, and they develop speech sound disorders (SSD). This study investigated predictive correlates of speech sound normalization in children who were at risk of SSD. Method: A prospective population cohort study of 845 Cantonese-speaking preschoolers was conducted over 2.5 years to examine (a) children who resolved nonadult realizations of consonants (normalized) and (b) those who had persisting speech sound difficulties (did not normalize). From these 845, a sample of 82 participants characterized as having SSD (1.25 SD s below the mean in a standardized speech assessment, with a delay in initial consonant acquisition or with one or more atypical errors) was followed for 2 years at 6-month intervals or until the completion of their initial consonant inventory. Data from 43 children who did not receive speech-language pathology services were analyzed with survival analysis to model time to normalization while controlling for covariates. The target event (outcome) was the completion of their initial consonant inventory. Results: Under the no-intervention condition, the estimated median time to normalization was 6.59 years of age. Children who were more likely to normalize or normalized in a shorter time were stimulable to all errors and more intelligible as rated by caregivers using the Intelligibility in Context Scale. Those who showed atypical error patterns did not necessarily take longer to normalize. Similarly, expressive language ability was not significantly associated with speech normalization. Conclusions: Stimulability and intelligibility were more useful prognostic factors of speech normalization when compared to (a)typicality of error patterns and expressive language ability. Children with low intelligibility and poor stimulability should be prioritized for speech-language pathology services given that their speech errors are less likely to resolve naturally.

Purpose: The aim of this pilot feasibility study was to evaluate the effectiveness of the group VietSpeech SuperSpeech program targeting speech skills and home language maintenance via telepractice. Method: In Stage 1, using a case–control design, 30 Vietnamese-English–speaking children were assessed in English and Vietnamese, and parents completed questionnaires about speech and language competency and practices. During Stage 2, children were allocated to intervention ( n = 14) or control ( n = 16) conditions. COVID-19 restrictions resulted in changes including nonrandom allocation. Online group intervention targeting speech, home language maintenance, and multilingualism as a superpower was delivered 1 hr/week for 8 weeks. For Stage 3, assessments were undertaken approximately 10 weeks after the pre-intervention assessment. Results: Parents in the intervention group significantly increased encouragement of their children to speak Vietnamese. The intervention group significantly increased intelligibility in English. Growth of Vietnamese vocabulary was faster for the control group. There was a moderate effect of intervention for children's perception of being happy talking in Vietnamese and English. There was no significant mean change from pre- to post-intervention compared with the control group for measures of speech sound accuracy in Vietnamese or English, Vietnamese intelligibility, English vocabulary, or hours of Vietnamese spoken each week. Conclusions: This study presents preliminary evidence that this 8-hr online group program targeting speech skills and home language maintenance had some impact on Vietnamese–Australian children's speech and home language maintenance. Further research involving a randomized trial is warranted.

Purpose: The aim of this study was to investigate Fijian students’ acquisition of Fiji English speech sounds. Method: Participants were 72 multilingual students (5–10 years) living in Fiji who spoke the Fijian or Fiji Hindi dialects of Fiji English. The students’ productions of single words from the Diagnostic Evaluation of Articulation and Phonology (DEAP) were analysed according to dialect using the Children’s Independent and Relational Phonological Analysis (CHIRPA). Result: Most English consonants were acquired by 6;0. English consonants that were not in the inventories of Fijian or Fiji Hindi were the last acquired, while those that were common between English and the two languages were some of the earlier acquired consonants. Percentage of consonants correct (PCC) for Fiji English was significantly lower for Grade 1 students (M = 93.01, SD = 0.07) in comparison to Grade 4 students (M = 99.03, SD = 0.01). Plosive and nasal sounds were acquired by 90% of the students earlier than fricative, approximant and affricate sounds, though acquisition of some plosive and fricative sounds varied between Fiji English dialects. All word-initial consonant clusters were acquired by 90% of the students by 9;6, with r-clusters tending to be the latest acquired. The acquisition of word-final consonant clusters was highly variable as students often produced appropriate dialectal variants. Conclusion: Multilingual Fijian children may acquire English specific sounds later than their monolingual English-speaking peers. Consideration of the language environment and analysis of the speech sample with reference to the child’s dominant English dialect is imperative for valid identification of speech sound disorder (SSD) in children who speak different dialects of English.

The Intelligibility in Context Scale (ICS) is a free parent-report screening tool that has been translated into over 60 languages. To date, there is cross-linguistic evidence regarding its validity...

Background: Many people with communication disorders wait for speech-language pathology services. Children may miss out on timely intervention and families may feel disempowered. Waiting list manag...

Purpose The aim of this study was to investigate children's acquisition of Vietnamese speech sounds. Method Participants were 195 children aged 2;2–5;11 (years;months) living in Northern Viet Nam who spoke Vietnamese as their 1st language. Single-word samples were collected using the Vietnamese Speech Assessment ( Phạm, Le, & McLeod, 2016 ) to measure accuracy of consonants, semivowels, vowels, and tones. Results Percentage of consonants correct for children aged 2;0–2;5 was 46.39 ( SD = 7.95) and increased to 93.13 ( SD = 6.13) for children aged 5;6–5;11. The most difficult consonants were /ɲ, s, z, x/. Percentage of semivowels correct for children aged 2;0–2;5 was 70.74 ( SD = 14.38) and increased to 99.60 ( SD = 1.55) for children aged 5;6–5;11. Percentage of vowels correct for children aged 2;0–2;5 was 91.93 ( SD = 3.13) and increased to 98.11 ( SD = 2.79) for children aged 5;6–5;11. Percentage of tones correct for children aged 2;0–2;5 was 91.05 ( SD = 1.42) and increased to 96.65 ( SD = 3.42) for children aged 5;6–5;11. Tones 1, 2, 5, and 6 were acquired by the youngest age group, whereas Tone 3 (creaky thanh ngã ) and Tone 4 (dipping–rising thanh hỏi ) did not achieve 90% accuracy by the oldest age group. Common phonological patterns (> 10%) were fronting, stopping, deaspiration, aspiration, and semivowel deletion for children aged 2;0–3;11 and were fronting and deaspiration for children aged 4;0–5;11. Conclusion This is the 1st comprehensive study of typically developing Northern Vietnamese children's speech acquisition and provides preliminary data to support the emerging speech-language pathology profession in Viet Nam.

Intelligibility of spoken languages is a widely discussed construct; however, intelligibility, as it pertains to signed languages, has rarely been considered. This study provides an initial investigation of the construct of intelligibility in American Sign Language (ASL) and evaluates potential measures for self-report and expert ratings of sign intelligibility that examined the frequency of understanding, amount of understanding, and ease of understanding. Participants were 66 college students (42 Deaf, 24 hearing) who had self-rated ASL skills ranging from poor to excellent. Participants rated their own intelligibility in ASL and then provided a signed language sample through a picture description task. Language samples were reviewed by an expert rater and measures of intelligibility were completed. Results indicated that expert ratings of sign intelligibility across all measures were significantly and positively correlated. Understanding of the signer was predicted by the amount of understanding, frequency of understanding, and ASL production skills, while understanding the picture being described was predicted by ease of understanding and ASL grammar skills. Self- and expert ratings of sign intelligibility using the ASL version of the Intelligibility in Context Scale were not significantly different. Self-report of sign intelligibility for viewers of different familiarity using the ICS-ASL was found not to be feasible due to many participants not being in contact with ASL users in the relationships defined by the measure. In conclusion, this preliminary investigation suggests that sign intelligibility is a construct worthy of further investigation.

Multilingual speakers’ ability to communicate effectively and intelligibly in the language of their country of residence is crucial to their participation. This study explored multilingual speakers...

Investigating children's feelings and attitudes toward talking assists speech–language pathologists (SLPs) to understand experiences of communication and the impact of speech sound disorders (SSD). This, in turn, can assist SLPs in identifying appropriate intervention for children with SSD that addresses the needs of children, and their communication partners. This paper draws on data from the Sound Start Study in Australia to explore the attitudes toward talking of 132 preschool-aged children with SSD and the relationship between children's attitudes, speech accuracy, and parent-reported intelligibility and participation. The study revealed most of the children with SSD had a positive attitude toward talking. There was a significant relationship between children's attitudes toward talking and speech accuracy. Furthermore, there was a significant relationship between speech accuracy and parents' perceptions of intelligibility and participation. However, there was no significant relationship between children's attitudes and parents' perceptions. These results highlight similarities and differences between attitudes and experiences of preschool-aged children, their performance on clinical measures, and their parents' perceptions, indicating the need for SLPs to consider each of these areas during assessment and intervention.

Purpose Diversification of the profession is an important element of combating racism, bias, and prejudice in the speech-language pathology workforce at national and systemic levels. However, national and systemic change needs to be combined with equipping individual speech-language pathologists to adapt to the challenges that they face to engaging in culturally responsive practice. This paper presents four interacting levels of practice within the Culturally Responsive Teamwork Framework (CRTF): (a) intrapersonal practices, (b) interpersonal practices, (c) intraprofessional practices, and (d) the interprofessional practices. Conclusion CRTF is a practical, strengths-based framework that draws on international research and expertise to expand personal and professional practice and describe critical behaviors within the workplace that can be used to promote principles of evidence-based practice and social justice, especially when working with people from nondominant cultural or linguistic groups.

Purpose Speech-language pathologists work with increasing numbers of multilingual speakers; however, even when the same languages are spoken, multilingual speakers are not homogeneous. Linguistic multicompetence (aka multi-competence) considers competency across all languages and is associated with multiple demographic, migration, linguistic, and cultural factors. Method This article examines the linguistic multicompetence of adults with Vietnamese heritage living in Australia ( n = 271) and factors associated with varying profiles of multilingualism. Participants completed a self-report questionnaire (available in English and Vietnamese) regarding their language proficiency and associated factors. Results Participants were largely (76.6%) first-generation migrants to Australia. Three distinct profiles of linguistic multicompetence were statistically identified using a cluster analysis: (a) Vietnamese proficient ( n = 81, 31%), (b) similar proficiency ( n = 135, 52%), and (c) English proficient ( n = 43, 17%); that is, half were proficient in both languages. Multinomial logistic regression analyses compared participants profiled as having similar proficiency with those who were more dominant in one language. Factors associated with the Vietnamese proficient group (compared with the similar proficiency group) were that the participants used Vietnamese much more than English with different people across different situations, were more likely to believe that maintaining Vietnamese helped them communicate in English, and earned less. Participants in the English proficient group used English more than Vietnamese with different people across different situations, were more likely to have lived in English-speaking countries longer, were younger in age, and were less likely to believe that maintaining Vietnamese helped improve academic study than those with similar proficiency. Conclusion Undertaking a comprehensive language profile is an important component of any multilingual assessment to enable speech-language pathologists to develop an understanding of different presentations of linguistic multicompetence, engage in culturally responsive practice, and acknowledge that high levels of competence can be achieved across multiple languages. Supplemental Material https://doi.org/10.23641/asha.14781984

Purpose This study investigated Icelandic-speaking children's acquisition of singleton consonants and consonant clusters. Method Participants were 437 typically developing children aged 2;6–7;11 (years;months) acquiring Icelandic as their first language. Single-word speech samples of the 47 single consonants and 45 consonant clusters were collected using Málhljóðapróf ÞM (ÞM's Test of Speech Sound Disorders). Results Percentage of consonants correct for children aged 2;6–2;11 was 73.12 ( SD = 13.33) and increased to 98.55 ( SD = 3.24) for children aged 7;0–7;11. Overall, singleton consonants were more likely to be accurate than consonant clusters. The earliest consonants to be acquired were /m, n, p, t, j, h/ in word-initial position and /f, l/ within words. The last consonants to be acquired were /x, r, r̥, s, θ, n̥/, and consonant clusters in word-initial /sv-, stl-, str-, skr-, θr-/, within-word /-ðr-, -tl-/, and word-final /-kl̥, -xt/ contexts. Within-word phonemes were more often accurate than those in word-initial position, with word-final position the least accurate. Accuracy of production was significantly related to increasing age, but not sex. Conclusions This is the first comprehensive study of consonants and consonant cluster acquisition by typically developing Icelandic-speaking children. The findings align with trends for other Germanic languages; however, there are notable language-specific differences of clinical importance.

Objective: To provide comparison data on the Intelligibility in Context Scale (ICS) for a sample of 3-year-old English-speaking children born with any cleft type. Design: Questionnaire data from the Cleft Collective Cohort Study were used. Descriptive and inferential statistics were carried out to determine difference according to children’s cleft type and syndromic status. Participants: A total of 412 children born with cleft lip and/or palate whose mothers had completed the ICS when their child was 3 years old. Main Outcome Measure(s): Mothers’ rating of their children’s intelligibility using the ICS. Results: The average ICS score for the total sample was 3.75 ( sometimes-usually intelligible; standard deviation [SD] = 0.76, 95% CIs = 3.68-3.83) of a possible score of 5 ( always intelligible). Children’s speech was reported to be most intelligible to their mothers (mean = 4.33, SD = 0.61, 95% CIs = 4.27-4.39) and least intelligible to strangers (mean = 3.36, SD = 1.00, 95% CIs = 3.26-3.45). There was strong evidence ( P < .001) for a difference in intelligibility between children with cleft lip only (n = 104, mean = 4.13, SD = 0.62, 95% CIs = 4.01-4.25) and children with any form of cleft palate (n = 308, mean = 3.63, SD = 0.76, 95% CIs = 3.52-3.71). Children born with cleft palate with or without cleft lip and an identified syndrome were rated as less intelligible (n = 63, mean = 3.28, SD = 0.85, 95% CIs = 3.06-3.49) compared to children who did not have a syndrome (n = 245, mean = 3.72, SD = 0.71, 95% CIs = 3.63-3.81). Conclusions: These results provide preliminary comparative data for clinical services using the outcome measures recommended by the International Consortium for Health Outcomes Measurement.

The emergence approach to speech acquisition theorises the influence of intrinsic capabilities (e.g., maturation), interactional capabilities, and extrinsic contexts (e.g., ambient phonology). Intrinsic and extrinsic influences were examined via a case study of a 3-generation Vietnamese-English family with two brothers (C1 aged 5;6 and C2 aged 3;10), their mother (M), grandfather (GF) and grandmother (GM). Their speech was assessed using the Diagnostic Evaluation of Articulation and Phonology (DEAP) and the Vietnamese Speech Assessment (VSA). Standard Australian English/Standard Vietnamese productions were defined as 'correct', even though the adults spoke different Vietnamese dialects. Their percentage of standard consonants correct (PSCC) was: C1 (English:92.27%, Vietnamese:89.05%), C2 (E:86.47%, VN:86.13%), M (E:90.34%, VN:96.35%), GF (E:82.61%, VN:97.81%), GM (VN:99.27%). Percentages were higher when dialectal variants were included. C1 and C2 had more pronunciation matches with English (86.96%) than Vietnamese (79.56%). C1's pronunciation matched: M (E:85.02%, VN:83.94%), GF (E:79.23%, VN:77.37%), GM (VN:73.72%) and C2's pronunciation matched: M (E:79.23%, VN:73.72%), GF (E:73.91%, VN:75.18%), GM (VN:72.26%). There was evidence of ambient phonology influences and cross-linguistic transfer. For example, in Vietnamese 'r' is produced as /ʐ/ or /r/ , but was produced by C1 as [ɹ] (English approximant) and by C2 [w] (age-appropriate/ɹ/substitution). The children demonstrated maturation influences for late-occurring English consonants (e.g., English /θ/ →[f]). This study found evidence for the emergence approach and recommends knowledge of the ambient phonology augments traditional child-focused understandings of children's speech acquisition.

This paper reports on 137 multilingual students enrolled at 14 English-speaking Australian universities who completed a 27-item online survey investigating the relationship between perceived English proficiency, intelligibility, and their academic, social and vocational participation. Open-ended responses described strategies used to enhance spoken English. Participants came from 44 countries and spoke 49 home languages. Self-ratings of English communication skills were significantly affected by age, English experience, number of languages spoken and home language. Participants reported spoken English proficiency impacted participation; however, results highlighted lack of awareness of intelligibility as an essential component of spoken language proficiency. Although environmental factors (e.g. more time using English in conversations) were associated with higher self-ratings of proficiency, participants preferred using individual strategies (e.g. listening/repeating) to support English intelligibility rather than social interactions with native speakers. The results demonstrate the importance of conversation practice in language learning to increase proficiency and confidence, as well as participation.

PurposeChildren with a cleft palate (± cleft lip; CP±L) can have difficulties communicating and participating in daily life, yet speech-language pathologists typically focus on speech production during routine assessments. The International Classification of Functioning, Disability and Health: Children and Youth Version (ICF-CY;World Health Organization, 2007) provides a framework for holistic assessment. This tutorial describes holistic assessment of children with CP±L illustrated by data collected from a nonclinical sample of seven 2- to 3-year-old children, 13 parents, and 12 significant others (e.g., educators and grandparents).MethodData were collected during visits to participants' homes and early childhood education and care centers. Assessment tools applicable to domains of the ICF-CY were used to collect and analyze data. Child participants' Body Functions including speech, language, and cognitive development were assessed using screening and standardized assessments. Participants' Body Structures were assessed via oral motor examination, case history questionnaires, and observation. Participants' Activities and Participation as well as Environmental and Personal Factors were examined through case history questionnaires, interviews with significant others, parent report measures, and observations.ResultsValuable insights can be gained from undertaking holistic speech-language pathology assessments with children with CP±L. Using multiple tools allowed for triangulation of data and privileging different viewpoints, to better understand the children and their contexts. Several children demonstrated speech error patterns outside of what are considered cleft speech characteristics, which underscores the importance of a broader assessment.ConclusionSpeech-language pathologists can consider incorporating evaluation of all components and contextual factors of the ICF-CY when assessing and working with young children with CP±L to inform intervention and management practices.

Purpose To use the ICF to classify characteristics and aspirations of multilingual university students and faculty who seek speech-language pathologists’ support for intelligibility in English and to identify activities, facilitators, and barriers that impact participation in society. Method A retrospective record review was conducted on files of 175 clients attending a university clinic for intelligibility enhancement (accent modification). Participants came from 35 countries and spoke 28 different home languages. Results Assessment and intervention for intelligibility enhancement involved consideration of ICF components of Body Functions and Structures (e.g., articulating phonemes, rate, prosody), Environmental Factors (e.g., support), and Personal Factors (e.g., motivation). Consonant substitutions and deletions were common, although participants were often unaware of these. For example, only 25.6% of participants reported English dental fricatives (/θ/ and /ð/) were difficult to pronounce; however, 94.9% substituted them with other phonemes such as [t] and [d]. The combination of substitutions/deletions, fast speech rate, low speaking volume, and differences in word stress exacerbated poor intelligibility. More time conversing in English was associated with greater confidence and less difficulty communicating in English, although more time knowing English was not. Difficult communication situations were reported to be conversing over the phone, talking to strangers, and communicating in English on professional fieldwork placements. Participants were motivated to seek intelligibility enhancement for academic, employment, and social reasons. Conclusions To ensure multilingual speakers are able to participate fully in society, intelligibility enhancement requires a multi-pronged approach where speech and environmental characteristics interweave.