Search

Purpose: The literature on postlaryngectomy voice and speech rehabilitation is long-standing. Although multiple rehabilitation options have existed over the years, the acquisition and use of esophageal speech (ES) has decreased significantly over the past 40 years. This reduction coincides with the increased application of tracheoesophageal puncture (TEP) voice restoration. The literature suggests that voice acquisition failures observed secondary to TEP may represent a similar phenomenon that led to ES acquisition failures. Method: A comprehensive review of the literature on ES and TEP voice/speech was conducted. Specific attention was directed toward information on ES and TEP speech failures. Information on pharyngoesophageal segment (PES) spasm in the context of ES and TEP voicing failures was of specific importance. Results: Similarities between voicing failures with both ES and TEP were identified. In order to resolve spasm in TEP speech, proactive efforts to eliminate it were undertaken, and regardless of the method used, voicing improvements were observed. These data suggest that both ES and TEP speech acquisition failures may be related to the same control mechanisms influencing the PES. Conclusions: The elimination of PES spasm provides evidence that justifies the reconsideration of ES. Consequently, ES may return as an increasingly viable postlaryngectomy voice and speech rehabilitation option., In 1980, postlaryngectomy voice and speech rehabilitation was revolutionized with the introduction of a surgical-prosthetic method termed tracheoesophageal puncture (TEP) voice restoration (Singer & Blom, 1980). This approach to voice [...]

Purpose: This study aimed to (a) relate temporal patterning of articulation to functional speech outcomes in neurologically healthy and impaired speakers, (b) identify changes in temporal patterning of articulation in neurologically impaired speakers, and (c) evaluate how these changes can be modulated by speaking rate manipulation. Method: Thirteen individuals with amyotrophic lateral sclerosis (ALS) and 10 neurologically healthy controls read a sentence 3 times, first at their habitual rate and then at a voluntarily slowed rate. Temporal patterning of articulation was assessed by 24 features characterizing the modulation patterns within (intra) and between (inter) four articulators (tongue tip, tongue body, lower lip, and jaw) at three linguistically relevant, hierarchically nested timescales corresponding to stress, syllable, and onset-rime/phoneme. For Aim 1, the features for the habitual rate condition were factorized and correlated with two functional speech outcomes--speech intelligibility and intelligible speaking rate. For Aims 2 and 3, the features were compared between groups and rate conditions, respectively. Results: For Aim 1, the modulation features combined were moderately to strongly correlated with intelligibility ([R.sup.2] = .51-.53) and intelligible speaking rate ([R.sup.2] = .63-.73). For Aim 2, intra-articulator modulation was impaired in ALS, manifested by moderate-to-large decreases in modulation depth at all timescales and cross-timescale phase synchronization. Interarticulator modulation was relatively unaffected. For Aim 3, voluntary rate reduction improved several intra-articulator modulation features identified as being susceptible to the disease effect in individuals with ALS. Conclusions: Disrupted temporal patterning of articulation, presumably reflecting impaired articulatory entrainment to linguistic rhythms, may contribute to functional speech declines in ALS. These impairments tend to be improved through voluntary rate reduction, possibly by reshaping the temporal template of motor plans to better accommodate the disease-related neuromechanical constraints in the articulatory system. These findings shed light on a novel perspective toward global timing-based motor speech assessment and rehabilitation., Speech is a hierarchical sound structure organized at multiple timescales representing different linguistic units including phonemes, syllables, words, and phrases (Poeppel, 2003; Poeppel & Assaneo, 2020). These linguistic units recur [...]

Purpose: Script training is a well-established treatment for aphasia, but its evidence comes almost exclusively from monolingual English speakers with aphasia. Furthermore, its active ingredients and profiles of people with aphasia (PWA) that respond to this treatment remain understudied. This study aimed to adapt a scripted-sentence learning protocol to Colombian Spanish speakers with aphasia, investigate speech entrainment (i.e., unison production of sentences) as an active ingredient for scripted-sentence learning, and identify patient profiles associated with better scripted-sentence learning. Method: Fourteen monolingual Spanish speakers with aphasia learned a set of 30 sentences. To examine speech entrainment as an active ingredient for scripted-sentence learning, we investigated whether sentences containing externally added rhythmic cues (involving stress-aligned vs. metronomic rhythmic cues) would result in better scripted-sentence learning compared with control sentences. Learning was measured via postsession probes and analyzed using mixed-effects logistic regression models. The relationship between scripted-sentence learning and baseline language and rhythmic processing measures was also examined. Results: Significant scripted-sentence learning over time indicated a successful adaptation of a script-training protocol to Spanish. PWA learned significantly more scripted sentences in the rhythmically enhanced conditions compared with the control condition. There were no differences between rhythmically enhanced conditions (stress-aligned vs. metronomic). In terms of patient profiles, it was found that PWA with more severe aphasia demonstrated larger learning gains, but rhythmic processing showed little association with learning estimates. Conclusions: To our knowledge, this study provides the first adaptation of a scripted-sentence learning protocol for monolingual Spanish speakers with aphasia, demonstrating cross-linguistic benefits of script training interventions. Highlighting rhythmic features during speech entrainment facilitated scripted-sentence learning in Spanish speakers with aphasia, suggesting that speech entrainment may be an active ingredient for scripted-sentence learning. More severe aphasia was associated with better scripted-sentence learning, suggesting that more severely impaired individuals are likely to benefit most from this treatment. Supplemental Material: https://doi.org/10.23641/asha.19241847, Understanding the connection between active ingredients and patient profiles associated with better response to evidence-based aphasia treatments is a necessary step to improve both the implementation and individualization of aphasia [...]

Purpose: A wealth of studies has assessed the diagnostic value of the nonword repetition task (NWRT) for the detection of developmental language disorder (DLD) in the clinical context of speech and language therapy, first in monolingual children and, more recently, in bilingual children. This review article reviews this literature systematically and conducts a meta-analysis on the discriminative power of this type of task in both populations. Method: Three databases were used to select articles based on keyword combinations, which were then reviewed for relevance and methodological rigor based on internationally recognized checklists. From an initial pool of 488 studies, 46 studies were selected for inclusion in the systematic review, and 35 of these studies could be included in a meta-analysis. Results: Most of the articles report significant discrimination between children with and without DLD in both monolingual and bilingual contexts, and the meta-analysis shows a large mean effect size. Three factors (age of the child, linguistic status, and language specificity of the task) yielded enough quantitative data for further exploration. Subgroups analysis shows variance in effect sizes, but none of the three factors, neither their interactions, were significant in a metaregression. We discuss how other, less explored factors (e.g., nature of the stimuli, scoring methods) could also contribute to differences in results. Sensitivity and specificity analyses reported in 33 studies confirmed that, despite possible effect size differences, the diagnostic accuracy of the NWRT is generally near thresholds considered to be discriminatory. It generally increases when it is combined with other tasks (e.g., parental questionnaire). Conclusions: This review indicates that the NWRT is a promising diagnostic tool to identify children with DLD in monolingual and bilingual contexts with a large mean effect size. However, it seems necessary to choose the precise NWRT materials based on the children's language background and to complement the assessment sessions with other tools in order to ensure diagnosis and to obtain complete language profile of the child. Supplemental Material: https://doi.org/10.23641/asha. 15152370, The ability to adequately repeat nonwords relies on many processes such as auditory perception, phonological encoding and assembly, storage of phonological representations, motor planning, and the ability to articulate (Coady [...]

Purpose: The purpose of this study was to compare the effect of speech intervention provided with a low intensity with speech intervention provided with a high intensity on the speech and health-related quality of life (HRQoL) in Dutch-speaking children with a cleft palate with or without a cleft lip (CP [+ or -] L) between 4 and 12 years. Method: A longitudinal, prospective, randomized controlled trial with a multiple baseline design was used. Twelve children with a Cp [+ or -] L ([M.sub.age] = 8.0 years, SD = 1.54) were divided into two groups using block randomization stratified by age and gender: One group received low-intensity speech intervention (LISI; n = 6) and one group received high-intensity speech intervention (HISI; n = 6). Children in the LISI group received intervention with a session duration of 1 hr, a dose frequency of 1 session per week, and a total intervention duration of 10 weeks. Children in the HISI group received intervention with a session duration of 1 hr, a dose frequency of 5 sessions per week, and a total intervention duration of 2 weeks. The cumulative intervention intensity was kept constant. Both groups received identical therapy programs provided by the same experienced speech therapist. Perceptual speech assessments were performed on baseline and posttreatment data points. Changes in HRQoL were assessed using the Velopharyngeal Insufficiency Effects on Life Outcomes (VELO) questionnaire. Both groups were compared over time using (generalized) linear mixed models. Results: No significant Time x Group interactions were observed for the percentage of correctly produced consonants at the word and sentence levels, indicating no differences in evolution over time among the two groups. The variables speech understandability, speech acceptability, and the total VELO scores significantly improved following HISI, but not following LISI. Conclusions: Children in the HISI group made equal and, for some variables, even superior progress in only 2 weeks of therapy compared to children in the LISI group who received 10 weeks of therapy. HISI is a promising strategy to improve speech outcomes and HRQoL in a shorter time period., The presence of active or compensatory speech errors severely impacts the speech understandability and speech acceptability of children with a cleft of the palate with or without a cleft of [...]

Purpose: Our aim was to assess the different voice prostheses (VPs) to identify the most efficient, safest, patient-tailored, longest lifetime, and inexpensive VPs and assess the different factors affecting their quality. Method: In September 2017, 15 databases were searched to include all randomized controlled trials. A new search was done in May 2019 to include all other study design articles, which include all the new-era VPs subtypes. Network meta-analysis (NMA) was applied to all 27 outcomes, besides NMA overall and partial order setting was done by using Hasse scatter plots. p values were used in NMA, where the best VPs are approaching one and the least approaches zero. Meta-analysis was done for the rest of the outcomes. Results: Two hundred one articles were eligible for inclusion in our study (N = 11,918). Provox-2 was significantly the most efficient and safest device concerning the most patient preference (odds ratio [OR] = 33.88 [0.65, 1762.24]; p = .92), the least dislodgement (risk ratio [RR] = 0.27 [0.13, 0.57]; p = .79), the least airflow resistance (RR = 0.42 [0.08, 2.11]; p = .84), the least granulation formation (RR = 0.73 [0.02, 26.32]; p = .60), and the least VPs' inaccurate size (RR = 0.77 (0.23, 2.61); p = .66). Heat and moisture exchanger addition showed a significant increase in maximum phonation time and breathing experience, with p values (1 and .59), respectively. While heat and moisture exchanger addition showed a significant decline in stoma cleaning frequency, coughing frequency, forced expectoration, sputum production, sleeping problems, and loosening of adhesive, with p values (.99, .72, .69, .96, 1, and 0.96), respectively, Groningen low resistance and Nijdam were considered the worst devices with both overall mean p value of .44. Conclusions: Provox-2 is considered the best choice as being the most preferable for patients, with the least airflow resistance, dislodgment, granulation formation, and prosthesis inaccurate size. Groningen low resistance and Nijdam were considered the worst devices according to our analysis. Supplemental Material: https://doi.org/10.23641/asha. 14802903, Laryngeal cancer is the most common malignancy of the head and neck, ranking the 19th globally with an estimated 13,150 new cases in the United States in 2018, as reported [...]

JASP-EMT, the combined Enhanced Milieu Teaching (EMT) and Joint Attention, Structured Play, and Emotion Regulation (JASPER) interventions, has been found to be effective for promoting social communication in young children with autism (Kasari et al. in J Am Acad Child Adolesc Psychiatry 53(6):635-646, https://doi.org/10.1016/j.jaac.2014.01.019, 2014). The current study examined the effects of this naturalistic intervention on social language use in three children with autism who were in the early stages of language acquisition. Generalization to communication partners who did not utilize the intervention strategies was systematically examined using a multiple-baseline design. The results from this study indicate that this blended intervention is effective in increasing target social language for young children with autism, however, generalization to communication partners does not readily occur. Implications for practice and future research are discussed., Author(s): Lauren H. Hampton [sup.1] [sup.2] , Ann P. Kaiser [sup.2] , Jennifer P. Nietfeld [sup.2] , Ani Khachoyan [sup.2] Author Affiliations: (1) grid.89336.37, 0000 0004 1936 9924, University of [...]

Purpose: We report on a replicated single-case design study that measured the feasibility of an expressive vocabulary intervention for three Cantonese-speaking toddlers with small expressive lexicons relative to their age. The aim was to assess the cross-cultural and cross-linguistic feasibility of an intervention method developed for English-speaking children. Method: A nonconcurrent multiple-baseline design was used with four baseline data points and 16 intervention sessions per participant. The intervention design incorporated implicit learning principles, high treatment dosage, and control of the phonological neighborhood density of the stimuli. The children (24-39 months) attended 7-9 weeks of twice weekly input-based treatment in which no explicit verbal production was required from the child. Each target word was provided as input a minimum of 64 times in at least two intervention sessions. Treatment feasibility was measured by comparison of how many of the target and control words the child produced across the intervention period, and parent-reported expressive vocabulary checklists were completed for comparison of pre- and postintervention child spoken vocabulary size. An omnibus effect size for the treatment effect of the number of target and control words produced across time was calculated using Kendall's Tau. Results: There was a significant treatment effect for target words learned in intervention relative to baselines, and all children produced significantly more target than control words across the intervention period. The effect of phonological neighborhood density on expressive word production could not be evaluated because two of the three children learned all target words. Conclusion: The results provide cross-cultural evidence of the feasibility of a model of intervention that incorporated a high-dosage, cross-situational statistical learning paradigm to teach spoken word production to children with small expressive lexicons., The purpose of this study was to test the feasibility of an expressive vocabulary treatment that was created for use with Western, English-speaking children for Cantonese-speaking children living in Hong [...]

Purpose: This study evaluates the effects of a novel speech therapy program that uses a verbal cue and gamified augmented visual feedback regarding tongue movements to address articulatory hypokinesia during speech in individuals with Parkinson's disease (PD).Method: Five participants with PD participated in an ABA single-subject design study. The treatment aimed to increase tongue movement size using a combination of a verbal cue and augmented visual feedback and was conducted in 10 45-min sessions over 5 weeks. The presence of visual feedback was manipulated during treatment. Articulatory working space of the tongue was the primary outcome measure and was examined during treatment and in cued and uncued sentences pre- and posttreatment. Changes in speech intelligibility in response to a verbal cue pre- and posttreatment were also examined.Results: During treatment, 4/5 participants showed a beneficial effect of visual feedback on tongue articulatory working space. At the end of the treatment, they used larger tongue movements when cued, relative to their pretreatment performance. None of the participants, however, generalized the effect to the uncued sentences. Speech intelligibility of cued sentences was judged as superior posttreatment only in a single participant.Conclusions: This study demonstrated that using an augmented visual feedback approach is beneficial, beyond a verbal cue alone, in addressing articulatory hypokinesia in individuals with PD. An optimal degree of articulatory expansion might, however, be required to elicit a speech intelligibility benefit., Parkinson's disease (PD) is the second most common degenerative disease of neurological origin (Bertram & Tanzi, 2005), and nearly 90% of individuals with PD develop a motor speech disorder affecting [...]

Purpose: This review article introduces research methods for personalization of intervention. Our goals are to review evidence-based practices for improving social communication impairment in children with autism spectrum disorder generally and then how these practices can be systematized in ways that personalize intervention, especially for children who respond slowly to an initial evidence-based practice.Method: The narrative reflects on the current status of modular and targeted interventions on social communication outcomes in the field of autism research. Questions are introduced regarding personalization of interventions that can be addressed through research methods. These research methods include adaptive treatment designs and the Sequential Multiple Assignment Randomized Trial. Examples of empirical studies using research designs are presented to answer questions of personalization.Conclusion: Bridging the gap between research studies and clinical practice can be advanced by research that attempts to answer questions pertinent to the broad heterogeneity in children with autism spectrum disorder, their response to interventions, and the fact that a single intervention is not effective for all children.Presentation Video: https://doi.org/10.23641/asha. 7298021, This research forum contains papers from the 2017 Research Symposium at the ASHA Convention held in Los Angeles, California.Autism spectrum disorder (ASD) represents a widely heterogeneous group of disorders that [...]

Purpose: The purpose of this study was to review treatment studies of semantic feature analysis (SFA) for persons with aphasia. The review documents how SFA is used, appraises the quality of the included studies, and evaluates the efficacy of SFA. Method: The following electronic databases were systematically searched (last search February 2017): Academic Search Complete, CINAHL Plus, E-journals, Health Policy Reference Centre, MEDLINE, PsycARTICLES, PsycINFO, and SocINDEX. The quality of the included studies was rated. Clinical efficacy was determined by calculating effect sizes (Cohen's d) or percent of nonoverlapping data when d could not be calculated. Results: Twenty-one studies were reviewed reporting on 55 persons with aphasia. SFA was used in 6 different types of studies: confrontation naming of nouns, confrontation naming of verbs, connected speech/ discourse, group, multilingual, and studies where SFA was compared with other approaches. The quality of included studies was high (Single Case Experimental Design Scale average [range] = 9.55 [8.0-11]). Naming of trained items improved for 45 participants (81.82%). Effect sizes indicated that there was a small treatment effect. Conclusions: SFA leads to positive outcomes despite the variability of treatment procedures, dosage, duration, and variations to the traditional SFA protocol. Further research is warranted to examine the efficacy of SFA and generalization effects in larger controlled studies., A persistent and frequent symptom of aphasia is anomia, which is a difficulty or inability to find the right word (Goodglass & Wingfield, 1997). Anomia has been described as 'the [...]

Purpose: In typical interactions with other speakers, including a clinical environment, listeners become familiar with voices through implicit learning. Previous studies have found evidence for a Familiar Talker Advantage (better speech perception and spoken language processing for familiar voices) following explicit voice learning. The current study examined whether a Familiar Talker Advantage would result from implicit voice learning. Method: Thirty-three adults and 16 second graders were familiarized with 1 of 2 talkers' voices over 2 days through live interactions as 1 of 2 experimenters administered standardized tests and interacted with the listeners. To assess whether this implicit voice learning would generate a Familiar Talker Advantage, listeners completed a baseline sentence recognition task and a post-learning sentence recognition task with both the familiar talker and the unfamiliar talker. Results: No significant effect of voice familiarity was found for either the children or the adults following implicit voice learning. Effect size estimates suggest that familiarity with the voice may benefit some listeners, despite the lack of an overall effect of familiarity. Discussion: We discuss possible clinical implications of this finding and directions for future research., Every year, nearly a million and a half children receive speech-language therapy under the Individuals with Disabilities Education Act (2004). To qualify for services, children are typically assessed using data [...]

Purpose: The aim of this study was to determine if a tablet-based home practice program with weekly telepractice support could enable long-term maintenance of recent treatment gains and foster new language gains in poststroke aphasia. Method: In a pre-post group study of home practice outcomes, 21 individuals with chronic aphasia were examined before and after a 6-month home practice phase and again at follow-up 4 months later. The main outcome measure studied was change in naming previously treated or untreated, practiced or unpracticed pictures of objects and actions. Individualized home practice programs were created in iBooks Author with semantic, phonemic, and orthographic cueing in pictures, words, and videos in order to facilitate naming of previously treated or untreated pictures. Results: Home practice was effective for all participants with severity moderating treatment effects, such that individuals with the most severe aphasia made and maintained fewer gains. There was a negative relationship between the amount of training required for iPad proficiency and improvements on practiced and unpracticed pictures and a positive relationship between practice compliance and same improvements. Conclusion: Unsupervised home practice with weekly video teleconferencing support is effective. This study demonstrates that even individuals with chronic severe aphasia, including those with no prior smart device or even computer experience, can attain independent proficiency to continue practicing and improving their language skills beyond therapy discharge. This could represent a low-cost therapy option for individuals without insurance coverage and/or those for whom mobility is an obstacle to obtaining traditional aphasia therapy., Aphasia is not a unitary disorder but, at its core, is a disabling impairment in the ability to retrieve words in spite of a preserved idea that fails to be [...]

Purpose: Children with speech and language disorders are at risk in relation to psychological and social well-being. The aim of this study was to understand the experiences of these children from their own perspectives focusing on risks to their well-being and protective indicators that may promote resilience. Method: Eleven 9- to 12-year-old children (4 boys and 7 girls) were recruited using purposeful sampling. One participant presented with a speech sound disorder, 1 presented with both a speech and language disorder, and 9 with language disorders. All were receiving additional educational supports. Narrative inquiry, a qualitative design, was employed. Data were generated in home and school settings using multiple semi-structured interviews with each child over a 6-month period. A total of 59 interviews were conducted. The data were analyzed to identify themes in relation to potential risk factors to well-being and protective strategies. Results: Potential risk factors in relation to well-being were communication impairment and disability, difficulties with relationships, and concern about academic achievement. Potential protective strategies were hope, agency, and positive relationships. Conclusion: This study highlights the importance of listening to children's narratives so that those at risk in relation to well-being can be identified. Conceptualization of well-being and resilience within an ecological framework may enable identification of protective strategies at both individual and environmental levels that can be strengthened to mitigate negative experiences., Speech, language, and communication disorders are relatively common in childhood, with prevalence rates ranging from 7% to 12% depending on the age groups studied, as well as the criteria and [...]

Purpose: This study examined effects of a peer-mediated intervention that provided training on the use of a speech-generating device for preschoolers with severe autism spectrum disorder (ASD) and peer partners. Method: Effects were examined using a multiple probe design across 3 children with ASD and limited to no verbal skills. Three peers without disabilities were taught to Stay, Play, and Talk using a GoTalk 4+ (Attainment Company) and were then paired up with a classmate with ASD in classroom social activities. Measures included rates of communication acts, communication mode and function, reciprocity, and engagement with peers. Results: Following peer training, intervention effects were replicated across 3 peers, who all demonstrated an increased level and upward trend in communication acts to their classmates with ASD. Outcomes also revealed moderate intervention effects and increased levels of peer-directed communication for 3 children with ASD in classroom centers. Additional analyses revealed higher rates of communication in the added context of preferred toys and snack. The children with ASD also demonstrated improved communication reciprocity and peer engagement. Conclusions: Results provide preliminary evidence on the benefits of combining peer-mediated and speech-generating device interventions to improve children's communication. Furthermore, it appears that preferred contexts are likely to facilitate greater communication and social engagement with peers., Many benefits of teaching young children with autism spectrum disorder (ASD) to use a speech--generating device (SGD) as an augmentative and alternative communication (AAC) system have been documented (see reviews [...]

Purpose: This study explored the effects of 2 different training structures on the implicit acquisition of a sequence in a serial reaction time (SRT) task in children with and without specific language impairment (SLI). Method: All of the children underwent 3 training sessions, followed by a retention session 2 weeks after the last session. In the massed-training condition, the 3 training sessions were in immediate succession on 1 day, whereas in the distributed-training condition, the 3 training sessions were spread over a 1-week period in an expanding schedule format. Results: Statistical analyses showed that the children with normal language were unaffected by the training conditions, performing the SRT task similarly in both training conditions. The children with SLI, however, were affected by the training structure, performing the SRT task better when the training sessions were spaced over time rather than clustered on 1 day. Conclusion: This study demonstrated that although intensive training does not increase learning in children with SLI, distributing training sessions over time does increase learning. The implications of these results on the learning abilities of children with SLI are discussed, as are the mechanisms involved in massed versus distributed learning., Specific language impairment (SLI) is a developmental language disorder that cannot be accounted for by hearing problems, nonverbal cognitive deficits, frank neurological damage, or environmental deprivation (Leonard, 2014). Children with [...]

Purpose: Ambulatory voice biofeedback has the potential to significantly improve voice therapy effectiveness by targeting carryover of desired behaviors outside the therapy session (i.e., retention). This study applies motor learning concepts (reduced frequency and delayed, summary feedback) that demonstrate increased retention to ambulatory voice monitoring for training nurses to talk softer during work hours. Method: Forty-eight nurses with normal voices wore the Voice Health Monitor (Mehta, Zanartu, Feng, Cheyne, & Hillman, 2012) for 6 days: 3 baseline days, 1 biofeedback day, 1 short-term retention day, and 1 long-term retention day. Participants were block-randomized into 3 different biofeedback groups: 100%, 25%, and Summary. Performance was measured in terms of compliance time below a participant-specific vocal intensity threshold. Results: All participants exhibited a significant increase in compliance time (Cohen's d = 4.5) during biofeedback days compared with baseline days. The Summary feedback group exhibited statistically smaller performance reduction during both short-term (d =1.14) and long-term (d = 1.04) retention days compared with the 100% feedback group. Conclusions: These findings suggest that modifications in feedback frequency and timing affect retention of a modified vocal behavior in daily life. Future work calls for studying the potential beneficial impact of ambulatory voice biofeedback in participants with behaviorally based voice disorders., Functional voice use is essential for most activities of daily living, such as communication and occupational demands (Roy, Merrill, Gray, & Smith, 2005). However, 3%-9% of the population is estimated [...]

Young children with neurodevelopmental disorders such as autism spectrum disorders (ASD) and Rett syndrome often experience severe communication impairments. This study examined the efficacy of parent-implemented communication assessment and intervention with remote coaching via telehealth on the acquisition of early communication skills of three young children with ASD (2) and Rett syndrome (1). Efficacy of the intervention was evaluated using single-case experimental designs. First, functional assessment was used to identify idiosyncratic/potentially communicative responses and contexts for each child. Next, parents implemented functional communication training (FCT). All of the children acquired the targeted communication responses. The findings support the efficacy of telehealth as a service delivery model to coach parents on intervention strategies for their children's early communication skills., Author(s): Jessica Simacek [sup.1] , Adele F. Dimian [sup.1] , Jennifer J. McComas [sup.1] Author Affiliations: (1) 0000000419368657grid.17635.36Department of Educational Psychology, University of Minnesota, 250 Education Sciences Building, 56 East [...]

Purpose: This study presents an application of the theoretical domains framework (TDF; Michie et al., 2005), an integrative framework drawing on behavior-change theories, to speech-language pathology. Methods: A multistep procedure was used to identify barriers affecting caregivers' implementation of shared-reading interventions with their children with language impairment (LI). The authors examined caregiver-level data corresponding to implementation issues from two randomized controlled trials and mapped these to domains in the TDF as well as empirically validated behavior-change techniques. Results: Four barriers to implementation were identified as potentially affecting caregivers' implementation: time pressures, reading difficulties, discomfort with reading, and lack of awareness of benefits. These were mapped to 3 TDF domains: intentions, beliefs about capabilities, and skills. In turn, 4 behavior-change techniques were identified as potential vehicles for affecting these domains: reward, feedback, model, and encourage. An ongoing study is described that is determining the effects of these techniques for improving caregivers' implementation of a shared-reading intervention. Conclusions: A description of the steps to identifying barriers to implementation, in conjunction with an ongoing experiment that will explicitly determine whether behavior-change techniques affect these barriers, provides a model for how implementation science can be used to identify and overcome implementation barriers in the treatment of communication disorders., Children with language impairment (LI) are highly susceptible to reading difficulties (RD; see Catts, Fey, Tomblin, & Zhang, 2002). For some children, this susceptibility is evidenced during the preschool years [...]

Purpose: Many well-accepted systems for determining difficulty level exist for books children read independently, but few are available for determining the wide range of difficulty levels of storybooks read aloud to preschoolers. Also, the available tools list book characteristics only on the basis of parents' or authors' opinions. We created an empirically derived difficulty-level system on the basis of 22 speech-language pathologists' (SLPs) judgments of specific storybooks used in preschooler read-alouds. Method: SLPs sorted 11 storybooks into ranked stacks on the basis of how difficult they thought the storybooks would be for preschoolers to understand when read aloud. SLPs described each stack globally as well as why they assigned each storybook to a particular stack. From transcriptions of the explanations, we derived a glossary of book characteristics using content analysis. We created a difficulty-level scale using a multivariate analysis technique that simultaneously analyzed book sorts and glossary terms. Results: The book selection system includes a glossary of book characteristics, a 4-level difficulty scale, and exemplar books for each level. Conclusion: This empirically derived difficulty-level system created for storybooks read aloud to preschoolers represents a step toward filling a gap in the read-aloud literature., Reading aloud to children is a critical activity for fostering the knowledge they need for later reading success (R. C. Anderson, Hiebert, Scott, Wilkinson, & The Commission on Reading, 1985). [...]