Cultural responsivity is an important aspect of evidence-based practice. When a speech-language pathologist is providing services to a child whose home environment does not represent the majority language or culture, special efforts are required to adapt to the values, beliefs, backgrounds, and experiences ofthefamilywhen selecting materials and designingtherapeutic activities. When providing services to children, the use of culturally appropriate storybooks is especially important to promote a sense of belonging and support co-creation of knowledge by the clinician and child. In this study, we asked speech-language pathologists from across Canada to complete a survey about their sociodemographic information, their practice and caseload, and their use of diverse literature with their pediatric clients. As expected, the survey revealed that speech-language pathologists in Canada were overwhelmingly white English-speaking women, even though their caseloads were somewhat orvery diverse with respect to racial and linguistic characteristics. The respondents in this study agreed that culturally responsive therapy materials were importantforthe children on their caseloads. However, one third used books that had no human characters, and anotherthird used books that presented white human characters. The speech-language pathologists reported barriers to obtaining culturally appropriate books, with insufficient resources and a lack of books being the most important.
Cultural responsivity is an important aspect of evidence-based practice. When a speech-language pathologist is providing services to a child whose home environment does not represent the majority language or culture, special efforts are required to adapt to the values, beliefs, backgrounds, and experiences ofthefamilywhen selecting materials and designingtherapeutic activities. When providing services to children, the use of culturally appropriate storybooks is especially important to promote a sense of belonging and support co-creation of knowledge by the clinician and child. In this study, we asked speech-language pathologists from across Canada to complete a survey about their sociodemographic information, their practice and caseload, and their use of diverse literature with their pediatric clients. As expected, the survey revealed that speech-language pathologists in Canada were overwhelmingly white English-speaking women, even though their caseloads were somewhat orvery diverse with respect to racial and linguistic characteristics. The respondents in this study agreed that culturally responsive therapy materials were importantforthe children on their caseloads. However, one third used books that had no human characters, and anotherthird used books that presented white human characters. The speech-language pathologists reported barriers to obtaining culturally appropriate books, with insufficient resources and a lack of books being the most important.
The purpose of this study was to evaluate the effectiveness ofa professional development program designed by speech-language pathologists to increase teachers' use of vocabulary strategies in low socioeconomic status preschools. Specifically, the teachers received a 12-week intervention, individualized in terms of the number and type of strategies taught and the length oftrainingfor each strategy. A book reading activity was used to practise the use of these strategies. Two parameters were evaluated to assess the effectiveness of this program: (a) use of the targeted strategies in a trained activity (book reading) and (b) generalization (teachers' application of the learned strategies to activities not directly trained in the program). To do this, a multiple case study was conducted with five preschool teachers. Followinga multiple baseline design, visual analyses and Tau statistics were used. The results showed a statistically significant increase in the use of targeted strategies in book reading, with large effect sizes regardless of the teacher or strategy taught. However, despite their mastery in book reading and theoretical information about how to generalize these practices, none of the teachers generalized the use of the strategies to other activities not targeted by the program. The results of this study underline the importance of providing intensive in situ training programs tailored to teachers' needs, including multiple opportunities for practice in different activities.
This project engaged speech-language pathologists (S-LPs) working with preschoolers to understand theirviews and identify their needs regarding the features and functions required fora digital participation-focused measure to be clinically useful. The Focus on the Outcomes of Communication Under Six (FOCUS-34) served as the measurement tool. Using principles of integrated knowledge translation, 23 preschool S-LPs were engaged in 60-min virtual focus groups to identify their perceived barriers and facilitators to using a digital FOCUS-34 and the features required fora digital measure to be helpful forfamilies, S-LPs, and programs. Participants completed an initial demographic survey and were then engaged in one of five virtual focus groups conducted using a semistructured interview guide. Quantitative survey data were analyzed descriptively, and qualitative focus group data were coded inductively and explored using content analysis. Two main categories were identified: (a) S-LPs' suggestions to support administration ofa digital FOCUS-34 and (b) S-LPs' suggested features to improve use of FOCUS-34 data in practice. Each main category included subcategories that described S-LPs' suggestions and requests. Integration of S-LPs' feedback is expected to support the development ofa digital FOCUS-34 that is clinically meaningful and useful. It is also expected to facilitate implementation ofa digital FOCUS-34 and improve the collection, interpretation, and use of participation-focused data in practice.
Primary progressive aphasia is a neurodegenerative disease characterized by a predominant and progressive communication impairment that affects the expression and comprehension of language. Recent studies have highlighted that people livingwith primary progressive aphasia and their caregivers often have difficultyaccessing complete and targeted information on the disease and its progression, and that community resources are very limited forthem. To address this problem, the community organization ART & Egrave;RE, Universit & eacute; Laval, and the Chaire de recherche sur les aphasies primaires progressives - Fondation de la famille Lemaire - worked together on the co-construction of the program Apprivoiser l'aphasie primaire progressive [Coping With Primary Progressive Aphasia]. A pilot project designed to improve the program was subsequently carried out before its deployment on a larger scale. This manuscript aims to (a) present the approach used to co-construct the program Apprivoiser l'aphasie primaire progressive, a psychoeducational program offering information and support to people livingwith primary progressive aphasia and their caregivers and (b) report the impacts of this program on basic knowledge and satisfaction of people livingwith primary progressive aphasia and theircaregivers via a posteriori analysis of the results of the pilot project. The five dyads who took part in the pilot project responded to a questionnaire on the state of their knowledge (before-after) as well as a satisfaction questionnaire (after). The results showed that bytaking part in the program, participants increased their knowledge about primary progressive aphasia and said theyfelt more prepared to face the future. The results also helped to adjust the structure of the program. This innovative, ready-to-use program is deployed throughout Qu & eacute;bec via associations of people livingwith aphasia.
Speech-language pathologists face a wide range of issues that call for a plurality of scientific approaches. This research note aims to introduce the transformative paradigm to the speech-language pathology community. This paradigm is particularly appropriate for addressing contemporary research issues such as health inequities. Under this paradigm, researchers position themselves in an important and avowedly pro- social justice way, rather than adopting an objectifying and "neutral" standpoint. This position arises from the idea that certain realities and knowledge are socially constructed and influenced by power dynamics rather than being absolute and invariable. Research can thus be an opportunity to help marginalized groups to be heard, typically by using qualitative or mixed methods. To shed light on how this paradigm can be employed in the field of speech-language pathology, we describe how the survey L'orthophonie pour toustes [Speech-Language Pathology for Everyone] was designed and face and content validated. We recruited a sample composed mainly of individuals from a disadvantaged group, and we used methods that positioned them as lived-experience experts. We discuss how these methodological choices brought strength to the project under the transformative paradigm perspective. Last, we argue for the importance of creating space in the scientific world of speech-language pathology for research projects positioned outside the dominant postpositivist paradigm in order to develop clinical services adapted to complex and dynamic societies.
Our aims were (a) to examine the growth trajectories of toddlers' social pragmatic communication using a standardized parent-report measure, the Language Use Inventory, and (b) to help distinguish typical variation and the potential for positive outcomes despite low initial functioning from trajectories that are suggestive of persistent language difficulties, and to thereby inform clinical practice and developmental surveillance with respect to 2-year-olds, for whom addressing late talking is of greatest concern. Parents of 138 2-year-olds completed the Language Use Inventory five times, at 3-month intervals from 24 to 36 months. Growth was examined using both children's total raw scores as defined for the measure and the corresponding percentile scores calculated according to the norms. Children's individual patterns of growth from 24 to 36 months showed a significant positive linear trend accompanied by significant variation in initial starting point and growth rate, with boys starting lower and growing faster than girls. Further exploration of the individual trajectories of 15 children initially falling at or below the 7(th) percentile at 24 months revealed two children with persistently low scores and the remainder moving outside of a realm of clinical concern by 36 months. Nevertheless, performance remained in the bottom tertile for the majority of this latter group. The findings further support existing recommendations for early, multiple-time-point surveillance of language using standardized measures in the 24- to 36-month period to aid in early identification of 2-year-olds who may benefit from intervention prior to the age of 3 years.
Satisfaction with communicative participation refers to a person's judgement of their own communicative participation, where communicative participation refers to the act of engaging in daily communicative situations. Measuring this concept as part of speech-language assessments allows clinicians to target relevant and meaningful therapy goals for each of their clients. However, to our knowledge, there are no tests assessing satisfaction with communicative participation in adults with acquired communication disorders. The goal of this article is to present the development and psychometric validity of the Echelle de satisfaction de la participation communicationnelle pour les personnes ayant un trouble acquis [Satisfaction With Communicative Participation Scale for People With Acquired Disorders]. This Quebec French assessment tool features 25 items, each referring to a potentially challenging communicative situation for an individual with an acquired communication disorder. The items are divided into five categories (oral expression, oral comprehension, written expression, written comprehension, and other communicative situations). This assessment tool demonstrates a good psychometric validity and can therefore be considered a good measure of satisfaction with communicative participation. In clinical contexts, the Echelle de satisfaction de la participation communicationnelle pour les personnes ayant un trouble acquis enables clients to identify the communicative situations that affect them the most. In that respect, this assessment tool is an excellent complement to objective speech-language pathology assessments, contributing to the selection of relevant and meaningful therapeutic goals.
Anomia, characterized by the inability to retrieve appropriate words for naming objects, people, and actions, is a prevalent phenomenon in neuropsychology and speech-language pathology. The assessment of naming deficits is crucial in various pathological conditions, including poststroke aphasia, primary progressive aphasia, and Alzheimer's disease. The Boston Naming Test is a widely used assessment tool for common-name anomia in North America. However, concerns about its psychometric qualities, cross-cultural validity, and differentiation among ethnic groups have raised questions about its diagnostic utility. This systematic review evaluates the psychometric properties of the 60-item version of the Boston Naming Test, specific to its use in the North American multicultural context. Although the Boston Naming Test has shown promise in distinguishing groups with different clinical conditions, issues regarding its cross-cultural validity and its ability to differentiate between ethnic groups persist. This review calls for further studies to explore these concerns and delve deeper into the psychometric properties of the Boston Naming Test. Despite the Boston Naming Test being known as a valuable diagnostic tool, its interpretation should be handled with caution and awareness of its limitations in diverse clinical, cultural, and population contexts. Considering the identified challenges, the development and standardization of a new object-naming test that addresses these issues appears to be a promising path forward.
There has been limited work to date capturing pediatric dysphagia services provided in Canada. The goal of this study was to describe current Canadian speech-language pathology practice in pediatric dysphagia using an online survey to inform understanding of potential barriers and opportunities. Of the 211 speech-language pathologists invited to participate in the survey, 177 responded, of which 72 reported working in pediatric dysphagia. Descriptive analysis was used to identify clinician demographics and practices for screening, assessment, and management of pediatric dysphagia. Most respondents (n = 40, 55.6%) worked in Ontario. The highest percentage of respondent caseload (M = 34%) was in pediatric outpatient rehabilitation settings. Of those working in pediatric dysphagia, 43 (59.7%) regularly screened for dysphagia and 58 (80.6%) conducted clinical dysphagia assessments. Although a high proportion of respondents (n = 68, 94.4%) reported having access to instrumental assessment, only 22 (32.8%) reported conducting instrumental assessments with pediatric patients. Various service delivery models were reported, including direct intervention, consultation, and caregiver/parent training. Thirty-nine (65%) respondents reported receiving specific pediatric dysphagia training during their professional academic program, with the majority (n = 19, 48.7%) reporting it to be a one-day course. Last, according to respondents, speech-language pathologists in Canada face multiple barriers related to pediatric dysphagia, including management by other professionals and lack of pediatric-specific training. Together these findings identified underutilized Canadian speech-language pathology resources in pediatric-specific dysphagia training, assessment, and interventions. There is a clear need to develop and disseminate curriculum standards to guide and support Canadian speech-language pathologists in pediatric dysphagia.
There is a high prevalence of late talkers, many of whom catch up to their peers without intervention. As publicly funded programs often have long wait times, evidence is needed to inform intervention intensity for this population. The aim of the study was to evaluate a low -intensity (three session, 4 hr) parent -implemented intervention based on parent and child outcomes. Parents and children were recruited during the initial assessment for a pre-post quasiexperimental study. At initial and reassessment, parents ( n = 67) completed a survey developed to measure confidence and behaviour and children's ( n = 89) communicative participation outcomes were measured using the Focus on the Outcome of Communication Under Six. Participants were grouped based on different intervention intensity that resulted from family attendance: experimental (all three sessions), partial control group (some sessions), and full control group (no sessions). Paired t tests and analysis of variance were used to identify differences across time (pre-post) and group. In parents, paired t tests detected statistically significant increases in the experimental and partial control groups. Similarly, clinically and statistically significant differences in Focus on the Outcome of Communication Under Six scores were observed pre- and postintervention in the experimental and partial control groups in children. Analysis of variance revealed no significant differences between experimental, partial control, or full control groups. Although no treatment effect for the low -intensity parent -implemented intervention model was found, this study raises important considerations of future research needs and current program decision-making for clinicians, service providers, and researchers.
As part of a continuous improvement process targeting speech -language pathology services offered to 4- and 5 -year -old children with developmental language disorders or a hypoth & egrave;se de trouble du langage (hypothesized language disorder), speech -language pathologists from the Centre int & eacute;gr & eacute; universitaire de sant & eacute; et de services sociaux de l'Estrie - Centre hospitalier universitaire de Sherbrooke teamed up with researchers from the Universit & eacute; du Qu & eacute;bec & agrave; Trois - Rivi & egrave;res to coconstruct recommendations concerning the provision of speech -language pathology services using evidence from literature and the expertise of speech -language pathologists. This collaborative action research project was carried out in three rounds of exchanges whose objectives were to promote dialogue, enrichment, and implementation of the coconstructed recommendations. Seven recommendations emerged from these exchanges. The first four focused on service paths, individualization of interventions, service delivery, and the number of goals to increase the specificity of the services. The other three recommendations focused on standardizing the services offered, increasing the frequency of interventions, and promoting greater involvement of parents to increase the intensity of the services. The barriers and facilitators related to the implementation of each recommendation were documented using the expertise of the participating speech -language pathologists. These recommendations, together with the scientific literature, will guide managers and speech -language pathologists as to which changes are required to improve the effectiveness of speech -language services for preschool children with developmental language disorders.
This brief report presents the results of an exploratory pilot study that evaluated the self -rated communication apprehension of eight control participants and eight older adolescents and adults with velopharyngeal insufficiency resulting from cleft palate with or without cleft lip. Participants in the experimental group were recruited from a hospital -based velopharyngeal dysfunction clinic and diagnosed with velopharyngeal insufficiency resulting from cleft palate with or without cleft lip by a board -certified otolaryngologist. All study participants completed the Personal Report of Communication Apprehension during a single experimental visit to evaluate self -reported communication apprehension. Significant differences in communication apprehension were found between groups, with the experimental group reporting higher levels of communication apprehension in comparison to the control group. More specifically, significant differences were found between groups for contexts related to communicating orally in group discussions, interpersonal conversations, public speaking, and overall communication apprehension. Our findings provide preliminary evidence that older adolescents and adults with a history of cleft palate with or without cleft lip and velopharyngeal insufficiency experience higher levels of communication apprehension in a variety of contexts requiring oral communication than control participants. Clinicians may wish to consider administering the Personal Report of Communication Apprehension as a screening tool as part of their clinical assessment, not only to broaden the scope of outcome measurement and to provide comprehensive, contextually relevant, and holistic care, but also to identify those individuals reporting high levels of communication apprehension so appropriate referrals and supports can be implemented.
This study investigated how well the air- and bone-conduction auditory steady-state response detected mild conductive hearing loss in young infants compared to the auditory brainstem response. Air-bone gap sizes were compared between infants with normal hearing and those with conductive loss using a two-group cross-sectional design. Twenty-three (500 Hz) and 22 (2000 Hz) infants (0-6 months of age) with normal hearing and 15 (500 Hz) infants with conductive loss were recruited from newborn hearing screening. Thresholds were obtained to frequency-specific air- and bone-conducted stimuli. There were no instances of conductive loss at 2000 Hz. Mean 500 -Hz thresholds and air-bone gap sizes were compared. Sensitivity and specificity for identifying conductive loss were measured. Overall, mean bone-conduction thresholds were similar between groups, and mean 500 -Hz air conduction thresholds were higher with larger air-bone gap size for infants with conductive loss. Sensitivity and specificity for identifying conductive loss were highest for air-conduction auditory brainstem response threshold measurement compared to screening and auditory steady-state response threshold measurements. Compared to the auditory brainstem response, the variability of auditory steady-state response thresholds and air-bone gap size was too great to reliably separate normal hearing from mild conductive loss. More research is needed using infants with varying degrees of hearing loss at multiple frequencies to fully assess the appropriateness of the auditory steady-state response as a clinical diagnostic tool for an infant population.
This exploratory research examined how Canadian parents perceived the impact of the COVID-19 pandemic on several aspects of their children's development, and whether these perceptions differed between parents of children with and without developmental difficulties. Pandemic -related restrictions limited social interactions, likely leading parents to have concerns about the impact of the pandemic on children's development of social skills. However, it was not clear if parents were concerned about the potential impact of the pandemic on other areas of child development, such as language and early literacy. To examine parents' perceptions of the impact of the COVID-19 pandemic on child development, we conducted an online survey with 253 parents of preschool -aged children. Survey items covered two domains: possible impacts of pandemic -related measures and concerns about specific developmental skills. Parents reported that the most negative impact on their children's development during the pandemic was limitations on playing with other children. They were particularly concerned about the impact on social skills, more so than on language and early literacy skills. The results also showed that parents who suspected that their children had a developmental difficulty were more concerned about the pandemic's impact on their children's development than parents of children with a diagnosis or no difficulties. We discuss the implications of these findings considering current research on the effects of the COVID-19 pandemic on children's language, early literacy, and social skill development.
Auditory processing and speech processing disorders negatively affect school -aged children. To minimize these negative effects, individuals in the risk group should benefit from the positive contribution of early intervention with a comprehensive evaluation. The aim of this study was to develop the Auditory and Speech Performance Test for Children and analyze its validity and reliability. In the development of the Auditory and Speech Performance Test for Children, discrimination and recognition subtasks were built for both auditory and speech performance. Meaningful and meaningless minimal pairs were used in the subtasks. A silent background was used for auditory performance, and noise stimuli were combined into minimal pairs for speech performance. Audiovisual materials were integrated into the finger-tapping test. The Auditory and Speech Performance Test for Children was administered to 307 children with typical development and to 80 children with specific learning disabilities. The Auditory and Speech Performance Test for Children calculated children's reaction times for pressing speed and accuracy of pressing the correct key. The data were analyzed for content, construct validity, internal consistency, and test -retest reliability. The content validity index value was found to be high (.89-1.0). The Auditory and Speech Performance Test for Children was explained as a two -factor model using exploratory factor analysis (eigenvalue = 1.92, total variance = 66.65%). It was found to be discriminative according to age, groups, subtests, and 27% bottom and top scores (all were significant atp < .001). Internal consistency (.77-.90) and test -retest values (.89-.93) of the Auditory and Speech Performance Test for Children in the total test scores were calculated within reliable values. In conclusion, we developed a valid and reliable screening tool for auditory and speech performance in children.
It has long been recognized that a quality speech sample is needed to assess individuals with velopharyngeal dysfunction. However, no list of controlled sentences in Qu & eacute;bec French has been published for the auditory -perceptual assessment of velopharyngeal function to date. The goal of this clinical project was therefore to develop and validate a list of controlled sentences in Qu & eacute;bec French. Using a deliberative inquiry, this action research project was carried out in collaboration with speech -language pathologists with expertise in resonance disorders and velopharyngeal dysfunctions in two phases: (a) creation of the list of sentences and (b) content validation of the sentences and documentation of their usage characteristics. In Phase 1, members of a community of practice developed 20 sentences based on specific phonetic -linguistic criteria. Phase 2 began by sending out a questionnaire to evaluate respect for and completeness of the criteria for each sentence and to document the contexts in which the tool was used. The questionnaire was completed by 13 speech -language pathologists who had used the list of sentences in their practice. Two group meetings were then held to discuss the final modifications to be made to the list. The expert speech -language pathologists considered the sentence list to have good content validity. They also recommend using the final version of the list of sentences when performing auditory -perceptual assessments of individuals aged 3-4 years to adulthood.
The Autism Diagnostic Observation Schedule (2nd edition, ADOS-2) shows excellent diagnostic accuracy when used with children suspected of having either autism or language/intellectual delays; however, its accuracy has been lower in children with psychiatric conditions. The purpose of this study was to determine the diagnostic accuracy of the ADOS-2 in pediatric psychiatry patients and to explore factors related to misclassification. Retrospective chart reviews for 84 consecutive autism query referrals in a local child psychiatry program were completed. Patient charts were reviewed for demographic and diagnostic information as well as scores on the ADOS-2 and the Children's Communication Checklist-2. Forty-four of 84 children were ultimately diagnosed with autism. Sensitivity of the ADOS-2 was 93% and specificity was 58%. Positive and negative predictive values were 71% and 89%, respectively. Thus, a negative result on the ADOS-2 was more informative than a positive result. The positive likelihood ratio showed a small difference, and the negative likelihood ratio showed a large difference. Overall, the ADOS-2 produced high rates of false positives in this pediatric psychiatry population. False positives were not related to the total number of psychiatric diagnoses children had received, but children diagnosed with attention-deficit/hyperactivity disorder and anxiety disorders were more likely to receive a false positive result.
Engaging teachers in professional development programs can be challenging. Modelling could make it easier for teachers to enroll in such programs because observing someone else may be less threatening than being observed and coached. More information on teachers' perceptions of in -class modelling would be useful in school settings as this professional development modality could be relevant when speech-language pathologists support teachers to implement supportive language practices. This study reports the perceptions of 28 kindergarten teachers regarding a professional development program with modelling as its main modality, using interactive book reading to foster language skills. The modelling was delivered by school-based speech-language pathologists in real settings. At the end of the program, the teachers completed a questionnaire which was analyzed quantitatively and qualitatively. The results gave information about four implementation outcomes. Acceptability: The respondents reported a high level of satisfaction with different aspects of modelling. Appropriateness: Respondents perceived relevant impacts of the program on their practices and on the children, with modelling being determinant to assimilate the content. Adoption: Most respondents reported changes in their practices and planned to make more in the upcoming year. Feasibility: Respondents suggested improvements to time-related features (for example, the length of the sessions) and better access to the books used. This study highlights the need for further research on modelling as a professional development modality in projects aiming to foster language skills. Also, being sensitive to the context of their practice settings, school-based speech-language pathologists could consider in-class modelling as a valuable modality when supporting teachers.
Communication partner training is typically designed to equip communication partners of adults with acquired neurogenic communication disorders with the necessary skills to create communication opportunities. Communication partner training allows for opportunities for expression, language expansion, enhanced interaction, participation, and well-being in these adults. However, successful implementation of communication partner training programs is not guaranteed as various factors, such as adult learning principles, the teaching style of the trainer, and trainee engagement, impact on the quality of training, and training outcomes predict training transfer. An umbrella review of systematic reviews was employed for this article. Initially the searches yielded 75 systematic reviews, in which 40 duplicates were identified. The remaining reviews (n = 35) were then screened on title, abstract, and full-text levels, resulting in a final inclusion of eight systematic review studies. A deductive approach to narrative synthesis was used to analyze the data based on previous theory. First, codes were identified, then themes, subthemes, categories, and subcategories were listed based on six adult learning principles and three trainee engagement components. This review highlights the importance of adult learning principles and trainee engagement when designing and implementing communication partner training within natural, real-life communication settings.
