Fort Hays State University, Hays, KS, USA. email@example.com
PURPOSE School-based speech-language pathologists (SLPs) routinely work with team members to make recommendations regarding an intervention program's intensity and method of service delivery for children with speech and language impairments. In this study, student, SLP, and workplace characteristics that may influence SLPs' recommendations were examined. METHOD Almost 2,000 school-based SLPs completed an online survey about the factors they consider when making recommendations regarding program intensity and service delivery model that students on their caseloads receive. RESULTS SLPs reported that student characteristics, rather than SLP or workplace characteristics, were the factors they considered the most when making these recommendations. However, these same SLPs reported that current students on their caseload with severe to moderate disabilities participated in intervention 2-3 times a week for 20-30 min in groups outside of the classroom. Students with the least severe disability received intervention 1 time a week for 20-30 min in groups outside of the classroom. CONCLUSION The limited variety of intervention program intensities and service delivery models used suggests that student characteristics may not be the most important factor considered when making intervention recommendations, as reported by the SLPs. Instead, caseload size and years of practice appear to influence SLPs' recommendations regarding which program intensity and service delivery models to use.
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Concurrent and construct validity of oral language measures with school-age children with specific language impairment.
University of Virginia, Charlottesville, USA. firstname.lastname@example.org
PURPOSE This study investigated the psychometric properties of 2 oral language measures that are commonly used for diagnostic purposes with school-age children who have language impairments. METHOD Two hundred sixteen children with specific language impairment were assessed with the Test of Language Development-Primary, Third Edition (TOLD-P:3; Newcomer & Hammill, 1997) and the Comprehensive Assessment of Spoken Language (CASL; Carrow-Woolfolk, 1999) within a 3-month period. The concurrent and construct validities of these 2 published tests were explored through correlation analysis and principle-component factor analysis. RESULTS The TOLD-P:3 Spoken Language Quotient and CASL Core Composite scores were found to have an intertest correlation value of r =.596 within this sample, and a paired samples t test revealed a statistically significant difference between these scores. Principle-component factor analyses revealed a 2-factor structure solution for the TOLD-P:3, whereas data from the CASL supported a single-factor model. CONCLUSIONS Analyses of assessment measure performance data from a sample of school-age children with specific language impairment revealed concurrent validity values and construct validity patterns that differed from those found in the norming samples as cited in examiner manuals. Implications for practice patterns and future research are discussed.
The effects of Fast ForWord Language on the phonemic awareness and reading skills of school-age children with language impairments and poor reading skills.
The University of Kansas, Department of Speech-Language-Hearing, 3042 Dole Building, Lawrence, KA 66045-2181, USA. email@example.com
PURPOSE To examine the efficacy of Fast ForWord Language (FFW-L) and 2 other interventions for improving the phonemic awareness and reading skills of children with specific language impairment with concurrent poor reading skills. METHOD A total of 103 children (age 6;0 to 8;11 [years;months]) with language impairment and poor reading skills participated. The children received either FFW-L computerized intervention, a computer-assisted language intervention (CALI), an individualized language intervention (ILI), or an attention control (AC) computer program. RESULTS The children in the FFW-L, CALI, and ILI conditions made significantly greater gains in blending sounds in words compared with the AC group at immediate posttest. Long-term gains 6 months after treatment were not significant but yielded a medium effect size for blending sounds in words. None of the interventions led to significant changes in reading skills. CONCLUSION The improvement in phonemic awareness, but not reading, in the FFW-L, CALI, and ILI interventions limits their use with children who have language impairment and poor reading skills. Similar results across treatment conditions suggest that acoustically modified speech was not a necessary component for improving phonemic awareness.
The efficacy of Fast ForWord Language intervention in school-age children with language impairment: a randomized controlled trial.
Ronald B Gillam, Diane Frome Loeb, Lavae M Hoffman, Thomas Bohman, Craig A Champlin, Linda Thibodeau, Judith Widen, Jayne Brandel, Sandy Friel-Patti
Utah State University, Logan, UT, USA. firstname.lastname@example.org
PURPOSE A randomized controlled trial was conducted to compare the language and auditory processing outcomes of children assigned to receive the Fast ForWord Language intervention (FFW-L) with the outcomes of children assigned to nonspecific or specific language intervention comparison treatments that did not contain modified speech. METHOD Two hundred sixteen children between the ages of 6 and 9 years with language impairments were randomly assigned to 1 of 4 conditions:(a) Fast ForWord Language (FFW-L),(b) academic enrichment (AE),(c) computer-assisted language intervention (CALI), or (d) individualized language intervention (ILI) provided by a speech-language pathologist. All children received 1 hr and 40 min of treatment, 5 days per week, for 6 weeks. Language and auditory processing measures were administered to the children by blinded examiners before treatment, immediately after treatment, 3 months after treatment, and 6 months after treatment. RESULTS The children in all 4 conditions improved significantly on a global language test and a test of backward masking. Children with poor backward masking scores who were randomized to the FFW-L condition did not present greater improvement on the language measures than children with poor backward masking scores who were randomized to the other 3 conditions. Effect sizes, analyses of standard error of measurement, and normalization percentages supported the clinical significance of the improvements on the Comprehensive Assessment of Spoken Language (E. Carrow-Woolfolk, 1999). There was a treatment effect for the Blending Words subtest of the Comprehensive Test of Phonological Processing (R. K. Wagner, J. K. Torgesen,& C. A. Rashotte, 1999). Participants in the FFW-L and CALI conditions earned higher phonological awareness scores than children in the ILI and AE conditions at the 6-month follow-up testing. CONCLUSION Fast ForWord Language, the intervention that provided modified speech to address a hypothesized underlying auditory processing deficit, was not more effective at improving general language skills or temporal processing skills than a nonspecific comparison treatment (AE) or specific language intervention comparison treatments (CALI and ILI) that did not contain modified speech stimuli. These findings call into question the temporal processing hypothesis of language impairment and the hypothesized benefits of using acoustically modified speech to improve language skills. The finding that children in the 3 treatment conditions and the active comparison condition made clinically relevant gains on measures of language and temporal auditory processing informs our understanding of the variety of intervention activities that can facilitate development.
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The World Report on Disability in relation to the development of speech-language pathology in Viet Nam.
Pham Ngoc Thach University of Medicine , Ho Chi Minh City , Viet Nam.
Wylie, McAllister, Davidson, and Marshall (2013) argue that recommendations made within the World Report on Disability provide an opportunity for speech-language pathologists to consider new ways of developing services for people with communication and swallowing disorders. They propose that current approaches to the delivery of speech-language pathology services are largely embedded within the medical model of impairment, thereby limiting the ability of services to meet the needs of people in a holistic manner. In this paper, the criticality of selecting an appropriate service delivery model is discussed within the context of a recently established post-graduate speech therapy education programme in Viet Nam. Driving forces for the implementation of the program will be explored, as will the factors that determined the choice of service delivery. Opportunities and challenges to the long-term viability of the program and the program's potential to meet the needs of persons with communication and swallowing disorders in Viet Nam will be considered.
Implementation of the World Report on Disability: Developing human resource capacity to meet the needs of people with communication disability in Uganda.
Speech and Language Therapy Unit, Makerere University , Uganda.
The World Report on Disability makes nine recommendations to ensure the inclusion, participation, and emancipation of people with disabilities. As described by Wylie, McAllister, Marshall, and Davidson (2013), the recommendations present a challenge for the development of services for people with communication disability (PWCD) in the Majority World, particularly recommendation 5:"increasing human resource capacity", since professionals with training in communication disability are often in extremely short supply. In partial answer to this situation in East Africa, a degree-level education programme for speech-language pathologists (SLPs) commenced in Uganda in 2008. This paper describes the establishment of that degree course, the current context of professional education, service development, and delivery, and describes how the World Report on Disability recommendation of increasing human resource capacity could be further addressed using culturally-appropriate, accessible, and innovative models of education. It highlights the need for a multi-strand and long-term approach to addressing communication disability at impairment, activity, and participation levels and offers a vision for the future of services in Uganda.
The ADEvantage Consulting, Leadville, Colorado.
Emphasis on classroom listening has gained importance for all children and especially for those with hearing loss and special listening needs. The rationale can be supported from trends in educational placements, the Response to Intervention initiative, student performance and accountability, the role of audition in reading, and improvement in hearing technologies. Speech-language pathologists have an instrumental role advocating for the accommodations that are necessary for effective listening for these children in school. To identify individual listening needs and make relevant recommendations for accommodations, a classroom listening assessment is suggested. Components of the classroom listening assessment include observation, behavioral assessment, self-assessment, and classroom acoustics measurements. Together, with a strong rationale, the results can be used to implement a plan that results in effective classroom listening for these children.
Pharmacological dosage concepts: How useful are they for educators and speech-language pathologists?
University of North Carolina-Greensboro , USA.
The first part of this response to Baker (2012) examines studies that have attempted to determine the optimum treatment intensity of reading interventions associated with a Response to Intervention (RTI) model of service delivery. In general, the findings indicated that differences in broad measures of intensity (duration and scheduling) did not result in differences in reading outcomes. These non-significant findings and Baker's excellent discussion of all of the factors that impact treatment outcomes led me to question how useful pharmacological dosage concepts are for educators and speech-language pathologists (SLPs). This commentary concludes by acknowledging that the more information available about the active ingredients of treatment episodes, the better able one will be to design effective and efficient interventions to improve speech, language, and literacy.
School of Psychology and Speech Pathology, Curtin University of Technology, GPO Box U1987 Perth Western Australia 6845, Australia. email@example.com
Within predominantly English-speaking countries such as the US, UK, Canada, New Zealand, and Australia, there are a significant number of people who speak languages other than English. This study aimed to examine Australian speech-language pathologists'(SLPs) perspectives and experiences of multilingualism, including their assessment and intervention practices, and service delivery methods when working with children who speak languages other than English. A questionnaire was completed by 128 SLPs who attended an SLP seminar about cultural and linguistic diversity. Approximately one half of the SLPs (48.4%) reported that they had at least minimal competence in a language(s) other than English; but only 12 (9.4%) reported that they were proficient in another language. The SLPs spoke a total of 28 languages other than English, the most common being French, Italian, German, Spanish, Mandarin, and Auslan (Australian sign language). Participants reported that they had, in the past 12 months, worked with a mean of 59.2 (range 1-100) children from multilingual backgrounds. These children were reported to speak between two and five languages each; the most common being: Vietnamese, Arabic, Cantonese, Mandarin, Australian Indigenous languages, Tagalog, Greek, and other Chinese languages. There was limited overlap between the languages spoken by the SLPs and the children on the SLPs' caseloads. Many of the SLPs assessed children's speech (50.5%) and/or language (34.2%) without assistance from others (including interpreters). English was the primary language used during assessments and intervention. The majority of SLPs always used informal speech (76.7%) and language (78.2%) assessments and, if standardized tests were used, typically they were in English. The SLPs sought additional information about the children's languages and cultural backgrounds, but indicated that they had limited resources to discriminate between speech and language difference vs disorder.
University of Nebraska-Lincoln, Lincoln, NE 68583-0731, USA. firstname.lastname@example.org
Qualitative methods were used to explore reactions of 300 speech-language pathologists (SLPs) on Response to Intervention (RTI). RTI is a system approach to serving struggling learners. This study was part of a larger research project that surveyed 2000 SLPs across the U.S. on their opinions about RTI. From 583 questionnaires returned, 300 (51.46%) responded to one open-ended question. Participants were asked,"What are your primary comments and/or concerns regarding RTI services for children and adolescents who struggle to learn?" Qualitative data analysis yielded 657 meaning units/codes and four themes emerged:(a) challenges and concerns,(b) support for the model,(c) implementation issues, and (d) role of SLPs. Challenges reflected in their reactions included:(a) the need for sufficient training,(b) SLPs' already heavy workloads,(c) concerns over students who may be "stuck in the tiers of RTI instruction" and the delay in timely referrals of students who need language services, and (d) having educational leaders that support RTI as well as the need for everyone to be "on board". RTI findings provide helpful considerations for SLPs and educators planning to implement the model.
Teachers' and speech-language pathologists' perceptions about a tangible symbols intervention: efficacy, generalization, and recommendations.
Boston College--Teacher Education, Special Education, Curriculum & Instruction, Chestnut Hill, Massachusetts 01721-3813, USA. email@example.com
Twenty-nine special education teachers (n=21) and speech-language pathologists (n=8) were interviewed about a tangible symbols intervention conducted with 51 children (3-21 years) with multiple disabilities and visual impairment. The intervention, which took place over a 7-month period, addressed the use of tangible symbols in the context of a structured protocol for implementing the daily schedule. These educators reported that students learned the meaning of symbols, exhibited improved behavior, and learned part or all of the daily routine, among other benefits. Supports and barriers to student learning (later coded as student characteristics or intervention characteristics) were discussed. Interviewees suggested improvements to the intervention and for generalization to the home setting, including labeling in the family's first language.
Clinical Professor Emeritus, University of California, San Francisco, San Francisco, California.
Speech-language pathologists (SLPs) in the public schools or other nonmedical settings rarely see infants or small children with unrepaired clefts. When children with repaired clefts appear in their caseloads, it may be difficult to comprehend what the situation was before the child had surgery. Clefts vary widely in their original severity, which has a direct bearing on how the repaired cleft looks and how the orofacial structures (lip, teeth, and palate) affect speech when the child comes into the SLP's caseload. It is important to understand that a high percentage of children with nonsyndromic clefts also have other structural or functional disorders that affect their ability to accomplish their goals in life. Multianomaly, complex craniofacial conditions (associations, sequences, and syndromes) are even rarer in nonmedically based SLP practices. However, because medical habilitation for these cases is now much more easily available and because families who frequent the Internet will know that the services of an SLP may be needed for their child, it is necessary for the SLP to know some basic characteristics of these conditions and to know where to find needed information.
A comparison of Malaysian and Australian speech-language pathologists' practices with children with developmental disabilities who are pre-symbolic.
Centre for Developmental Disability Health Victoria, Monash University, Melbourne, Australia. firstname.lastname@example.org
The aim of this study was to explore the assessment, intervention, and family-centred practices of Malaysian and Australian speech-language pathologists (SLPs) when working with children with developmental disabilities who are pre-symbolic. A questionnaire was developed for the study, which was completed by 65 SLPs from Malaysia and 157 SLPs from Australia. Data reduction techniques were used prior to comparison of responses across questionnaire items. Results indicated that SLPs relied mostly on informal assessments. Malaysian and Australian SLPs differed significantly in terms of obtaining information from outside the clinic to inform assessment. When providing intervention, SLPs focused mostly on improving children's pre-verbal skills. A third of Australian SLPs listed the introduction of some form of symbolic communication as an early intervention goal, compared to only a small percentage of Malaysian SLPs. Regarding family involvement, SLPs most often involved mothers, with fathers and siblings being involved to a lesser extent. Overall, it appeared that practices of Malaysian SLPs had been influenced by developments in research, although there were some areas of service delivery that continued to rely on traditional models. Factors leading to similarities and differences in practice of SLPs from both countries as well as clinical and research implications of the study are discussed.
Expectations and experiences of accessing and participating in services for childhood speech impairment.
Mayne School of Medicine, The University of Queensland, Herston, Australia. email@example.com
Speech impairment (speech sound disorder) is a high prevalence condition that responds well to early intervention provided by speech-language pathologists (SLPs). However, not all children in Australia are able to access necessary speech-language pathology services. The aim of this research was to investigate Australian parents' experiences of accessing and engaging in speech-language pathology services for their children with speech impairment. Two studies were conducted to achieve this aim. In Study 1, questionnaires were completed by 109 parents of pre-school children who had been identified with concerns about their speech. Only a third (n = 34, 31.2%) of the parents had previously accessed speech-language pathology services for assessment of their children's speech and just 29 of these (26.6% of the entire sample) reported their children had received intervention. Two thirds (n = 68, 62.4%) of the parents had not sought speech-language pathology services and half of these (n = 35, 32.1% of the entire sample) reported that "services were not needed". There was a small number of parents (n = 7, 6.4%) who had attempted to access services but had been unsuccessful. Parents identified teachers, family, friends, and doctors as important sources of information about their children's speech. In Study 2, interviews were conducted with 13 of the parents to discuss their experiences of speech impairment and service delivery in greater depth. Parents expected that others would make them aware of their child's speech impairment and that they should be able to access speech-language pathology services when required. Consequently, there is a need to raise awareness about speech impairment and speech-language pathology services to ensure appropriate identification, referral, and service provision for children at risk.