PURPOSE:In the context of limited understanding of the objective measurement of diadochokinesis in adults with stuttering, the study aimed to compare the oral diadochokinetic and laryngeal diadochokinetic rates between adults who stutter and adults who do not stutter. The study further examined the effect of lexicality (real words vs. non-words) in oral diadochokinetic tasks. METHOD:Using Praat software, oral (oral diadochokinetic rate, consonant-vowel duration, and inter-syllabic duration) and laryngeal diadochokinetic rates were examined among 35 adults who stutter and 35 age- and gender-matched adults who do not stutter. Further, the effect of stimuli (real word vs. non-word) during oral diadochokinetic tasks was also examined. RESULT:Significant differences were noted between groups for monosyllabic oral and laryngeal diadochokinetic rates, but not during bi- and tri-syllabic diadochokinetic tasks, suggesting potential differences in speech-motor control between the groups. There was no significant difference between groups in consonant-vowel duration and inter-syllabic duration. In contrast to adults who do not stutter groups, a significant difference was observed with adults who stutter producing bi-syllabic real words faster than the non-words. CONCLUSION:The present study emphasises the importance of using the dual diadochokinetic protocol (oral and laryngeal diadochokinetic), incorporating both real and non-word oral diadochokinetic tasks during clinical evaluations.
PURPOSE:While evidence supports use of the Lidcombe Program for school-age children who stutter, accessing treatment can be problematic. Telepractice could overcome service barriers, yet scarce research has investigated telepractice delivered Lidcombe Program by school speech-language pathologists. METHOD:In this pragmatic pilot study, 16 school-age children (6;1-11;2) received the Lidcombe Program via telepractice at home or school by one of five offsite speech-language pathologists. Independent speech data were collected before treatment and nine months after commencing treatment. Additionally, data regarding parent satisfaction and perspectives were collected. RESULT:After nine months of treatment, speech data were collected from 10 of the 16 children, five of whom had already met criteria for entry to Lidcombe Program Stage 2. The remaining six children withdrew prior to this data-point. Significant group reductions in percentage of syllables stuttered (p = .05) and severity ratings (p = .05) were achieved, however should be interpreted with caution given varied participant treatment response. Parents reported that telepractice was convenient, increased access, and did not negatively impact the speech-language pathologists' therapeutic relationship. CONCLUSION:Reductions in stuttering, along with positive parent reports, mean telepractice delivered Lidcombe Program by school speech-language pathologists can be effective for some children while overcoming access barriers.
PURPOSE:This study describes the carer- and self-reported mealtime challenges for children and young people with cerebral palsy. These data are novel and incorporate the consumer's perspective to inform service delivery. METHOD:Participants included children and young people with cerebral palsy (aged 1-26 years) or their caregivers in Western Australia. Participants wrote comments to two open-ended questions regarding causes of coughing or choking during meals from a larger survey on respiratory risk factors. These written responses form the dataset for the present study. Data were analysed using thematic analysis. RESULT:Of 551 respondents, 272 answered the open-ended questions (n = 255 carer-reported, n = 17 self-reported; mean age of children and young people with cerebral palsy = 10.6 years [SD = 6.1]; n = 160 male; n = 54 V on the Gross Motor Functional Classification Scale; n = 85 with texture modifications and/or tube). Only 8.1% reported no safety concerns at mealtimes. The issues respondents reported around mealtime challenges and safety were collated into five themes: (a) types of food and drink, (b) oral skills and swallow function, (c) mealtime behaviours, (d) mealtime assistance, and (e) health and medical issues. CONCLUSION:This study identifies key mealtime challenges for children and young people with cerebral palsy. Clinical practice recommendations are provided. They involve multifactorial assessment, individualised planning, and multidisciplinary management.
PURPOSE:Paediatric Feeding Disorder occurs when oral intake is not age-appropriate and associated with impaired medical, nutritional, feeding skill, and/or psychosocial dysfunction. Psychometric properties of feeding assessments are variable, with unclear mapping to the Paediatric Feeding Disorder criteria. We aimed to explore paediatric feeding and swallowing assessment tools mapped to Paediatric Feeding Disorder domains and narratively analyse the psychometric properties. METHOD:This systematic scoping review utilised three databases (Medline, Embase, Web of Science). Studies written in English regarding children 0;6 months to 3;11 years with psychometrics on assessment of Paediatric Feeding Disorder were included. RESULT:32,322 papers met inclusion criteria, and 137 papers were included in final extraction. Ninety-five feeding assessments were identified; 66.3% parent-reported questionnaires, 31.6% clinician assessments, and 2.1% clinician or caregiver rating scales. Of these, 87% of assessments included a combination of Paediatric Feeding Disorder domains. Psychometric properties were reported on 520 occasions, the highest being internal consistency (13.5%). CONCLUSION:Diagnosis of Paediatric Feeding Disorder requires use of feeding assessments with the strongest psychometric evidence to comprehensively assess all four Paediatric Feeding Disorder domains. Assessments should incorporate parent-reported and clinician assessment to synergise caregiver perspectives with clinical expertise. Further research is needed to enhance reliability and validity testing of paediatric feeding assessments to form a comprehensive Paediatric Feeding Disorder diagnosis.
PURPOSE:Speech-language pathology has traditionally been informed by sender-receiver models of communication and medicalised frameworks that prioritise impairment, diagnosis, and measurable outcomes. While these approaches have contributed substantially to clinical assessment and intervention, they can underrepresent relational, social, and embodied dimensions of communication that shape participation in everyday life. We argue that expanding the theoretical foundations of speech-language pathology through engagement with dialogic, sociological, and philosophical perspectives can enrich contemporary practice. Drawing on the work of sociological philosophers we explore communication as a dynamic, co-constructed, and polyphonic process in which meaning emerges through interaction, embodiment, and encounter. METHOD:We reflect on three qualitative research projects involving people with communication disabilities. Across these examples, dialogic concepts illuminate aspects of practice that are often difficult to capture through conventional frameworks, including relational attunement, embodied knowledge, ethical responsiveness, and co-construction of meaning. RESULT:Dialogic conceptualisations of communication offer speech-language pathologists a broader professional vision that extends beyond impairment-focused models towards more collaborative, person-centred, and contextually situated practice. CONCLUSION:Dialogism offers concepts that can advance assessment, intervention, professional education, and research; greater engagement with theory can support more ethical, creative, and inclusive approaches to communication support.
PURPOSE:Limited diversity in speech-language pathology is an issue as populations served become increasingly diverse. This study provides the first overview of demographic diversity within the German speech-language pathology workforce and examines discrimination experiences across multiple dimensions, with comparisons to national population statistics where possible. METHOD:A nationwide cross-sectional online survey using a 65-item self-identification questionnaire was conducted. Fully completed responses from speech-langauge pathologists (n = 1580) were analysed descriptively. Variables included age, gender, sexual orientation, citizenship/nationality, immigration history, ethnic origin/racialisation, religion/belief, language, disability, qualification pathways, and self-reported discrimination. Data were collected via LimeSurvey following guidance from the Federal Anti-Discrimination Agency. RESULT:The workforce was predominantly female (91.3%) and White (93.16%). Respondents with an immigration history (18.29%) and Muslim affiliation were comparatively underrepresented compared with the general population. Sexual orientation and overall religious affiliation broadly aligned with population estimates. Heritage-language proficiency in major migrant languages was limited. Overall, 69% reported experiencing discrimination at least occasionally, most commonly based on gender. Respondents with an immigration history more often reported multiple perceived bases of discrimination. CONCLUSION:The German speech-language pathology workforce appears demographically homogenous, particularly regarding ethnicity/racialisation and heritage-language diversity. Discrimination is common. These findings provide a baseline for understanding workforce diversity and relate to United Nations Sustainable Development Goals 3, 4, 5, 8, and 10.
PURPOSE:To investigate the types of coping strategies used by carers of people with aphasia and the ways these coping strategies interact with the positive and negative impact of caring on daily life. METHOD:The Ways of Coping Questionnaire was completed by 11 carers of people with aphasia. Six carers also completed in-depth semi-structured interviews. Coping strategies were classified according to the original 8-factor structure of the Ways of Coping Questionnaire. Interviews were analysed using qualitative content analysis to map findings to the International Classification of Functioning, Disability, and Health framework and thematic analysis to identify key themes. RESULT:The questionnaire revealed that participants mostly used strategies that have previously been found to be beneficial for adjustment but provided novel insight that self-controlling behaviours were frequently used. The interviews provided finer grained insight into aphasia-specific coping behaviours and a broader understanding of the effects of caregiving on participants' daily lives. Three of the key themes (emotional self-control, positive reappraisal, and the need for time to oneself) were findings that converged across methods. CONCLUSION:The research identified practical ways to help carers of people with aphasia. Some would require systemic change, however others could be more easily implemented. Further investigation of the coping strategies used by carers of people with aphasia could help to guide intervention and support specific to this population.
PURPOSE:The Lidcombe Program is an evidence-based treatment for early stuttering. Although negative attitudes towards direct stuttering therapies have previously been reported among Turkish speech-language pathologists, these data are outdated, and this study updates the field by examining current perceptions and experiences with the Lidcombe Program. This study explored Turkish clinicians' perceptions, practices, and challenges in delivering pre-school stuttering therapy, with a focus on the Lidcombe Program. METHOD:An explanatory sequential mixed-method design was employed. In Phase 1, 121 Turkish speech-language pathologists completed a cross-sectional survey on early stuttering therapy. In Phase 2, eight speech-language pathologists participated in semi-structured interviews analysed using reflexive thematic analysis. RESULT:Survey findings indicated that the Lidcombe Program was the most frequently used therapy for preschoolers who stutter, particularly among more experienced clinicianss, despite few having completed formal Lidcombe Program training (e.g. a Lidcombe Program Trainers Consortium workshop). Most respondents expressed interest in Lidcombe Program training and emphasised the need for Turkish-language resources. Interviews highlighted two main challenges: Limited training opportunities and implementation difficulties, including variable parental engagement and language-related barriers. CONCLUSION:Barriers such as scarce Turkish-language training and resources may impact speech-language pathologists' confidence in delivering the Lidcombe Program. Expanding culturally and linguistically appropriate training, including accessible online modules, may improve uptake and implementation.
PURPOSE:The progression of Parkinson's disease is known to lead to dysarthria, but the occurrence and impact of word-finding difficulties on communication has been less studied. The objective of this study was to explore the experiences of word-finding difficulties in everyday life among people with Parkinson's disease. METHOD:Semi-structured, in-depth interviews were performed with individuals diagnosed with Parkinson's disease. The interviews were transcribed and analysed with an inductive approach using conventional qualitative content analysis. RESULT:Fifteen participants (mean age 72 years and varying in degree of severity and time since diagnosis) were included. Three main categories emerged in the analysis: (a) Word-finding difficulties have consequences in everyday life, (b) Influencing factors in a variable word-finding ability, and (c) Coping with word-finding difficulties. The result showed that word-finding difficulties affected the participants to variable extents and that access to communicative strategies also varied. Changes in communicative participation were described along with factors affecting the word-finding ability, for example, health status and contextual factors like conversation partners. CONCLUSION:Word-finding difficulties may impact the daily lives of people with Parkinson's disease. Speech-language pathologists can play a key role in assessing word-finding ability and assisting in development of functional communication strategies, involving family members and professional carers.
PURPOSE:Genuine engagement in paediatric speech-language pathology is co-constructed by families and speech-language pathologists over time. However, research about how speech-language pathologists work with families to understand and respond to their needs is limited. This project aimed to design a toolkit to facilitate shared conversations about engagement in an early intervention service for children (0-8 years). METHOD:In Phase 1, focus groups with speech-language pathologists (n = 20) explored key aspects of engagement and generated ideas for tools. In Phase 2, an online survey with these clinicians explored the format of two tools: 1) A template for 'getting to know a family', and 2) a 'living document' to record goals and have conversations about working together. In Phase 3, separate focus groups were conducted with clinicians (n = 20) and parents (n = 9) to design and refine the tools. RESULT:Reflexive thematic analysis of Phase 1 data resulted in two overarching themes: 1) Engaging with families at the start; and 2) Reflecting with families throughout their journey. Content analysis of Phase 2 survey responses informed draft tools. Phase 3 findings informed the final tools. CONCLUSION:This project identified opportunities to support engagement and developed a toolkit to facilitate conversations between families and speech-language pathologists in early intervention.
PURPOSE:This study aimed to address limitations in international equivalence and psychometric quality of the Japanese version of the Stroke and Aphasia Quality of Life Scale-39 (SAQOL-39-J). We developed the SAQOL-39-J without illustrations (SAQOL-39-J-ni) to enhance international comparability and assessed its acceptability, reliability, and validity. METHOD:We recruited 100 participants (mean age = 61.64 years), including 92 individuals with post-stroke aphasia. Acceptability was examined through skewness, ceiling, and floor effects. Reliability was evaluated via internal consistency and test-retest reliability. Validity included assessments of internal and convergent validity. RESULT:Eight items (20.51%) did not meet skewness criteria, but the deviation was minor. No ceiling or floor effects were observed. Cronbach's α was 0.95, and test-retest reliability showed an ICC of 0.94 (95% CI: 0.86-0.97). Inter-item correlations ranged from rho = 0.21-0.79, and convergent validity showed total score correlations rho = -0.01-0.45. CONCLUSION:The SAQOL-39-J-ni demonstrated strong psychometric properties comparable to international versions. It is a reliable outcome measure for people with aphasia in Japan, supporting both clinical use and cross-cultural research.
PURPOSE:This project examines how speakers adjust their voices in response to multisensory and unisensory simulations in virtual reality. METHOD:Forty-one young adults produced reading and spontaneous speech samples in three simulation conditions: Multisensory audiovisual virtual reality, audio-only auralisations, and visual-only virtual reality environments. Acoustic voice parametres included sound pressure level, fundamental frequency, cepstral peak prominence smoothed, pitch strength, and time dose. Participants also provided self-reported ratings of vocal effort, fatigue, and discomfort on visual analog scales. RESULT:Multisensory simulations significantly influenced sound pressure level, fundamental frequency, pitch strength, and self-reported vocal effort compared to unisensory simulations. Female participants exhibited strong vocal adjustments to auditory input, while task demands (reading versus spontaneous speech) consistently altered vocal outcomes. Phonation time was elevated in audio-only auralisations. CONCLUSION:Our findings demonstrate that voice production adjusts to audiovisual input in virtual reality, with multisensory simulations producing distinct outcomes from audio-only or visual-only conditions. Implementing multisensory simulations might improve voice recordings collected in traditional laboratory or clinical contexts, which may fail to reflect everyday communication. More broadly, the findings reinforce the multisensory nature of vocal motor control, as audiovisual input tended to exert stronger effects on voice outcomes than unisensory input.
PURPOSE:We aimed to provide an overview of measurement instruments available to speech-language pathologists for evaluating acquired non-progressive dysarthria in Arabic-speaking adults; evaluate the availability, clinical utility, and psychometric properties of instruments to inform clinical practice; and examine how closely instruments align with the domains of the International Classification of Functioning, Disability and Health framework to help set priorities for future dysarthria assessment development. METHOD:The systematic review was guided by PRISMA standards, involving seven databases and manual searching. The process of searching, screening, and data extraction was carried out by two reviewers. The selected studies met predetermined inclusion criteria. Quality of evidence and psychometric data of tools were investigated using: GRADE, MMAT, and COSMIN. RESULT:Fourteen measurement tools for assessing non-progressive dysarthria in Arabic-speaking adults were identified in the literature. Tools grouped into three categories: Those used in their original format, those which had been translated and adapted, and those specifically developed for Arabic-speaking individuals. Most tools addressed the impairment domain, with limited focus on activity and participation domains. CONCLUSION:The available tools demonstrated limited clinical availability and insufficient psychometric evidence, highlighting the need for further validation and the development of linguistically and culturally appropriate tools for Arabic-speaking populations, and tools that address all International Classification of Functioning, Disability and Health framework domains.
PURPOSE:Speech-language pathologists have important opportunities to deliver culturally and linguistically appropriate services for children with complex communication needs. International research has explored services in relation to available augmentative and alternative communication systems and collaboration with families, yet little is known about Australian speech-language pathologists' practices. The present study explores how Australian speech-language pathologists carry out their work with children with complex communication needs in multilingual families. METHOD:Twenty-three (n = 23) Australian speech-language pathologists participated in semi-structured interviews about their experiences working with children who have complex communication needs in multilingual families. Transcribed interview data were analysed with a thematic analysis approach. RESULT:One of the four main themes is explored in this paper, specifically how speech-language pathologists work to address challenges in providing interventions. Participants described how they work to: (a) Align their own and family expectations, (b) find shared and relevant ways to communicate with families, and (c) tailor resources to child and community needs. CONCLUSION:Findings raise similar challenges to international studies in this area, including the complexity of creating multilingual augmentative and alternative communication systems or adapting existing systems. Participants' experiences demonstrate both positive achievements or gains towards meeting families' needs and identify challenges faced.
PURPOSE:This scoping review aimed to synthesise empirical studies on communication access during face-to-face service encounters in the service sector for people who have communication support needs in low-and middle-income countries. METHOD:The methodological framework by Arksey and O'Malley guided this review. Studies were identified from nine electronic databases and independently screened for inclusion. Data were extracted aligned to the research questions and the environmental categories highlighted in the International Classification of Functioning, Disability and Health. RESULT:Sixty studies met the inclusion criteria. Most studies focused on communication access for people who are hard of hearing or d/Deaf and service encounters in health care services. Various barriers and facilitators were identified, including factors related to the service system, policies, assistive technology, and the physical environment. The attitudes, knowledge, and skill of service providers were frequently mentioned as barriers. CONCLUSION:A variety of factors influencing communication access were identified in the review. Many of these are amenable to change and may be productively addressed to increase communication access for people who have communication support needs. Studies are needed to document the development, implementation, and effects of integrated and comprehensive intervention efforts in close collaboration with people who have communication support needs.
PURPOSE:With increasing numbers of adolescents reporting mental health concerns, speech-language pathologists across clinical sectors need greater awareness of the potential impact of mental health concerns on assessment performance. The aim of this study is to examine factors that influence speech-language pathologists' clinical approach to assessing adolescents, focusing on adolescents with mental health concerns. The study offers insights from the clinical experiences, thoughts, and concerns from speech-language pathologists working with this population. METHOD:An online survey gathered data from speech-language pathologists working with adolescents, inviting them to describe their approach to assessing adolescents with and without mental health concerns. Responses of 35 speech-language pathologists were drawn from four open-ended questions and analysed using reflexive thematic analysis. RESULT:Responses generated six themes: (a) The whole adolescent, (b) the adolescent's voice, (c) creating connection, (d) purpose guides assessment, (e) broadening assessment, and (f) working within the clinical context. A final theme was created reflecting concern expressed for equipping speech-language pathologists to work in the mental health space. CONCLUSION:Speech-language pathologists need to be aware that adolescent clients may be experiencing co-occurring mental health concerns that can impact assessment performance and accommodate this by adapting their clinical approach, while ensuring sensitivity for both communication and potential mental health needs.
PURPOSE:This paper explores the deeper, personal side of dementia care, focusing on connection and the importance of learning from the stories and experiences of people with dementia to inform practice and ways of working. METHOD:A reflective and integrative approach is used to explore the relationship between memory, communication, identity, participation, and citizenship, through the lens of connection. Insights from previous research and reflections on practice are synthesised to identify ways that speech-language pathologists can promote personhood, strengthen relationships, and respond to changes in memory and communication over time and with the progression of dementia. RESULT:Nine key actions are presented that encourage and empower speech-language pathologists to reflect on ways of working and the relational skills needed to hold people with dementia in connection-connection with self, connection with others, and connection with community. The actions span the continuum of care and consider individual and community levels of practice. CONCLUSION:The paper provides direction for the speech-language pathology profession through advocacy, innovation, and partnership to advance creative, empowering, and inclusive ways of optimising moments of connection, quality of life, and meaningful engagement in and beyond dementia care.
PURPOSE:This study examined the word and nonword reading abilities of Maltese participants with Down syndrome and explored how cognitive-linguistic skills and orthographic depth influence decoding performance. We hypothesised that word reading would exceed nonword reading in participants with Down syndrome, with a larger discrepancy in English given its deeper orthography. METHOD:A comparative cross-sectional design was used. Fifteen participants with Down sydnrome and 19 typically developing peers, matched on fluid intelligence, completed word and nonword reading assessments in either Maltese or English. Cognitive measures included phonological awareness, visual perceptual processing, verbal short-term memory, receptive vocabulary, and sentence imitation. Non-parametric tests compared groups and within-group analyses examined associations between reading outcomes and subskills. RESULT:Preliminary result shows that participants with Down syndrome performed comparably to typical developing peers on word and nonword reading. However, participants with Down syndrome showed significantly better performance on word than nonword reading in both languages, with a larger discrepancy in English than in Maltese. In English, visual-perceptual skills and vocabulary were associated with reading, whereas these links were weaker in the Maltese subgroup. CONCLUSION:In this population, orthographic depth shapes decoding patterns. Interventions should emphasise phonological training while accounting for differences between shallow and deep orthographies.
