Phonological development is critical for children's language development and literacy - and yet, it poses unique challenges for bilingual children with cochlear implants (CI), particularly in linguistically diverse societies. This study addresses the dearth of culturally and linguistically appropriate phonological assessment tools through the development and validation of a bilingual Urdu-English Phonology Test (UEPT), designed to assess phonological skills in children aged 3-6 years. Urdu-English bilingual children with normal hearing (NH) and hearing-age-matched children with CIs across four age groups (3.0-3.11, 4.0-4.11, 5.0-5.11, and 6.0-6.11 years) were assessed through spontaneous naming of 136 English-Urdu pictures. Validation was achieved through calculations of item-level (I-CVI), scale-level (S-CVI) content validity indices, internal consistency (Cronbach's alpha), inter-rater reliability (Cohen's kappa), test-retest reliability (ICC), and construct validity. The UEPT had a content validity [S-CVI = 90.1% (Urdu); 96.9% (English)], with Cohen's Kappa = 0.84, for CIs and 0.933 for NHs on Urdu-English (UE) pictures. High internal consistency (alpha = 0.95 for Urdu and 0.97 for English), strong inter-rater reliability (kappa = 0.85 for CIs & 0.93 for NHs) and test-retest reliability (ICC = 0.92 for CIs and 0.97 for NHs) were obtained on SPSS. Significant age-related score differences supported construct validity. The Urdu-English Phonology test is a reliable, culturally and linguistically relevant tool for assessing phonological acquisition in preschool bilingual UE children, addressing the need for the assessment of the CI population, providing insights for clinicians and researchers. It supports collecting normative data for better management of speech sound disorders in bilingual UE children with Normal Hearing and Cochlear Implant.
The Pacific Islands encompasses a linguistically and culturally diverse geographical region. Most Pacific Island countries have few speech-language pathology services. In Pacific Islander diaspora communities around the world these children may seek support from speech-language pathologists (SLPs) where these children are among a cultural and/or linguistic minority. This study aimed to identify if children with Pacific Islander heritage are accessing speech-language pathology services in English-speaking countries, and to seek SLPs' perspectives on the provision of culturally responsive speech-language pathology services for these children and their families. This mixed methods study collected quantitative and qualitative data via an online survey, answered by 57 SLPs and assistants in English-speaking countries (Australia, Aotearoa, Canada, United States, United Kingdom). Qualitative responses were analysed thematically using the Principles of Culturally Responsive Practice (Verdon et al., 2015). Almost half (47%) of participants had provided communication support for children with Pacific Islander heritage. Participants reported varying approaches to providing culturally responsive services for Pacific Islander children and families, including collaboration with families and cultural support workers and using dynamic and/or informal assessment practices, usually in English. Participants identified a lack of culturally and linguistically appropriate assessment and intervention resources to support these children and their families. Further development of culturally and linguistically appropriate communication assessment and intervention resources, in collaboration with Pacific Islander communities, is essential to support culturally responsive speech-language pathology services for children with Pacific Islander heritage.
PurposeAugmentative and Alternative Communication (AAC) is still emerging in India, and its use is shaped by multiple contextual factors. This study explored the perceived barriers and facilitators influencing AAC implementation for children with autism spectrum disorder (ASD) from the perspectives of speech-language pathologists (SLPs), special educators, and parents.MethodsForty-two participants - SLPs (n = 27), special educators (n = 10), and parents (n = 5) took part in online semi-structured interviews. Data were transcribed verbatim and analyzed using inductive thematic analysis guided by Braun and Clarke's framework. Frequency counts were used to capture the prevalence of key ideas.ResultsFive themes emerged: (1) family and caregiver related factors, (2) professional and training factors, (3) systemic and environmental factors, (4) AAC-related and technological factors, and (5) child-related factors. Major barriers included limited awareness and acceptance among parents, inadequate training for professionals, high device costs, lack of institutional support, and social stigma. Facilitators included parental motivation, professional collaboration, technological innovation, and culturally relevant AAC tools.ConclusionsAAC implementation in India is influenced by interrelated personal, professional, and systemic factors. Enhancing AAC training, communication partner education, and inclusive policy initiatives may strengthen adoption and improve outcomes for children with ASD.
This study examines the perspectives of Vietnamese speech-language pathology (SLP) mentees, their Minority World SLP mentors, and supporting interpreters following participation in an intercultural telementoring program. Using a quantitative design, the study investigated participants' perceptions of their professional achievements, the usefulness of various mentoring tools, and the suitability of mentor-mentee matching within the program. Descriptive statistical analyses were employed to explore trends across participant groups. All participant groups, mentees, mentors, and interpreters derived meaningful, role-specific benefits from participation. Mentees, in particular, described substantial gains in articulating, refining, and implementing professional development goals. Across groups, closer mentor-mentee alignment was associated with greater perceived benefit. Mentees and mentors consistently endorsed the full suite of mentoring tools as supporting engagement and learning, whereas, interpreters reported more variable utility, noting that several tools were less relevant to their role. Overall, the results suggest that intercultural telementoring is a viable and effective strategy for expanding access to professional development for Majority World health practitioners. The model not only supports mentee growth but also promotes reciprocal learning and cross-cultural exchange among all participants in the mentoring partnership.
Speech language pathologists (SLPs) support adolescents and adults who stutter to ameliorate the negative impact that often occurs. Most research involving this population has focused on their lived experiences, treatment efficacy, and stuttering impact. There has been little exploration of SLP perspectives or experiences. This study investigates the practices, perceptions and confidence of SLPs who work with adolescents and adults who stutter and explores possible barriers and facilitators to successful treatment. In this qualitative study, six Australian SLPs who work with adolescents or adults who stutter were interviewed using a semi-structured interview approach. Data were analysed using interpretative phenomenological analysis. Analysis identified four themes: (1) working with adolescents and adults who stutter is complex and includes specific differences between the two age groups; (2) SLP confidence develops with experience and professional development, and can lead to tension between evidence-based practice and clinical judgement; (3) assessment, goal setting and treatment is individualised and should be client-directed; and (4) SLPs may not work with PWS due to experience, education or the complexity of stuttering. Insights into SLPs' practices and perspectives may assist in improving the efficiency and efficacy of treatment and future education of SLPs.
The Hui Process is a Maori framework designed initially for medical students to enhance their interactions with patients, particularly when working with Maori (Lacey et al., 2011). This study examined Speech-Language Therapy (SLT) and Audiology student perspectives and experiences of engaging with the Hui Process. This research employed a qualitative and Kaupapa Maori approach. This involved the conduct of semi-structured interviews around the perspectives and experiences of students on using the Hui Process in clinical practice. Fifteen participants who had recently graduated from completing a Bachelors or Masters of Speech-Language Pathology, or Masters of Audiology, were involved in this study. The interviews were analyzed using thematic analysis. Three themes were generated, and the findings suggest that whakawhanaun-gatanga is central to the student experience of following the Hui Process, shaping how students build meaningful connections with those they work with. Educators are pivotal in influencing whether and how students use the Hui Process in placement settings. The students reported varied learning experiences, highlighting the need for more applied, practice-based, and individualized teaching approaches to support under-standing and application. This study highlights how speech-language therapy and Audiology students engage with the Hui Process in clinical practice. Strengthening educator capability, increasing opportunities for applied learning, and supporting flexible, student-centered teaching approaches may enhance student confidence and consistency in using the Hui Process in culturally safe ways.
Creating a classroom environment conducive to communication is vital for children's success. The aim of this paper was to conduct an umbrella review to synthesize what is known and not known about the effect of the classroom environment during different characterized activities on school children's hearing, listening, comprehending, and communicating using the Listen to Learn for Life Assessment Framework. The Joanna Briggs Institute protocol for umbrella reviews was followed. Twenty-two review papers met the criteria to be included in the umbrella review. Overall, poorer acoustic conditions, such as long reverberation times and high noise levels, resulted in poorer listening and comprehending during lecture and group work activities, with the effect greater for younger children. A dysphonic voice could also impede comprehension. Therefore, to improve students' listening and comprehension, noise should be controlled, acoustic treatment should be installed, sound-field amplification should be used, speaker-to-listener distance should be minimized, and open-plan classrooms should be avoided. Future research is needed on the impact of visual and spatial aspects of the classroom, as few review papers were found on these aspects. Additionally, future research is needed on how the classroom environment affects bidirectional communication between student and teacher as well as student and student.
The pediatric videofluoroscopic swallow study (VFSS) is a specialized procedure, with speech pathologists (SPs) requiring additional training prior to independent clinical practice. Given the limited available research examining pediatric VFSS training methods, this study aimed to investigate self-reported learner outcomes of a virtual multicomponent education program (facilitator-led peer learning groups and eLearning package). Using a prospective pre-post evaluation design, SPs in Queensland (Australia) were recruited to participate in the program over a 12-month period. The eLearning package consisted of seven modules, which provided information about preparing for, conducting, and interpreting pediatric VFSS. Twelve 60-minute online facilitator-led peer learning groups were offered, incorporating didactic presentations, professional discussions, and inter-rater reliability activities. Participants completed questionnaires regarding demographics, self-reported confidence, case management, overall and individual session satisfaction. Overall, 30 speech pathologists participated in this project. A significant increase in self-reported confidence was reported on 20/21 parameters, and 95% of participants attributed this to the virtual learning program. No significant changes were observed on the case management questionnaire. Participants reported high levels of overall satisfaction with the virtual education program (mean rating 4.3/5), with the use of interactive learning (e.g., videos, case studies) and peer-discussion reported to be highly beneficial. Overall, results highlighted that interactive, peer-based online training methods were well-accepted and resulted in improvements in self-reported confidence. Future research should investigate the impacts of virtual training on clinician performance and patient outcomes.
Prevalence and long-term impact of communication and swallowing difficulties on ability to readjust after spinal cord injury (SCI) have been understudied. This study aimed to explore self-reported communication and swallowing difficulties in patients following SCI throughout their rehabilitation journey. 123 patients completed self-reported questionnaires at three time points: upon arrival at rehabilitation, at discharge and one month after discharge. All patients completed the Voice Handicap Index 10 (VHI-10), the Eating Assessment Tool (EAT-10), and the Communication Participation Item Bank (CPIB). Scores were compared across time periods. Forty-four percent of patients (71% male, mean age 54 yrs) had a cervical SCI, and 24% had an American Spinal Injury Association (ASIA) score of A (complete impairment). On admission to rehabilitation, 22% of patients had elevated EAT-10 and 12% had elevated VHI-10. Scores improved for similar to 50% of patients. The VHI-10, EAT-10 and CPIB were significantly worse for those who had required speech-language therapy (SLT) and those with cervical SCI and higher ASIA scores (p < 0.05). Only 8% of patients had received SLT during rehabilitation; 18 patients (15%) did not receive SLT input during their acute or rehabilitation stay despite self-reported swallowing (n = 5), voice (n = 6) or both swallowing and voice (n = 7) concerns. A proportion of patients in SCI rehabilitation reports concerns with their swallowing and/or voice. For some, this continues long after discharge. SLT should be available for SCI rehabilitation to support the return to enjoyable, safe oral intake and optimise communication skills. Validated self-reported questionnaires provide a simple way of identifying patients who require SLT.
This study aimed to develop and validate the Japanese version of the Pediatric Eating Assessment Tool (PediEAT-J). The original PediEAT underwent forward-backward translation and cultural adaptation. Caregivers of 697 children aged 6 months-7 years completed the PediEAT-J. A subset of 70 caregivers repeated the questionnaire after two weeks to assess test-retest reliability. Internal consistency was evaluated with Cronbach's alpha; reliability with the intraclass correlation coefficient (ICC). Construct validity was examined via confirmatory factor analysis (CFA) of the original four-factor model; discriminant validity was examined by comparing scores of children with caregiver-reported feeding concerns to those without. Internal consistency was high across subscales and the total score (alpha = 0.806-0.913). Test-retest reliability was excellent (ICC = 0.902). Model-fit indices were acceptable: comparative fit index = 0.889; Tucker-Lewis index = 0.867; root mean square error of approximation = 0.039 (90% CI: 0.036-0.041); standardized root mean square residual = 0.071. Children whose caregivers expressed feeding concerns scored significantly higher than those without concerns on total and subscale scores (all p < 0.01), confirming discriminant validity. The PediEAT-J is a reliable and valid Patient-Reported Outcome Measure (PROM) that enables comprehensive assessment of feeding difficulties in Japanese children aged 6 months-7 years. It supports clinical assessment and intervention by providing structured caregiver-reported data on a child's feeding skills.
Care for individuals with laryngectomy (IWL) is complex, requiring access to specialized multidisciplinary services along the full care continuum. However, evidence supports that challenges are experienced by some IWL accessing supportive care, with current care systems not addressing patients' postoperative and long-term needs, contributing to poor outcomes and increased patient and caregiver burden. This study explored perceptions of IWL about overall health services and speech-language pathology (SLP) care to identify and prioritize opportunities for supportive care optimization. Concept mapping methodology was used to identify what IWL perceived were important to support their care. Through the multistep concept mapping process, qualitative and quantitative data were used to identify, then prioritize, critical elements of care that IWL feel should be optimized in the care pathway. Fourteen IWL from two health services generated 32 unique statements. Hierarchical cluster analysis revealed that statements fell within seven clusters: (1) comprehensive healthcare professional access and support; (2) psychological care and trust in healthcare; (3) supporting adjustment to life after surgery; (4) managing the treatment and recovery pathway; (5) communication restoration and peer-support; (6) inpatient care; and (7) no underlying theme. The Go-Zone map revealed 15 statements that were rated highest for importance, with the majority of these focusing on improving psychological care and adjustment postsurgery. IWL identified and prioritized actions to enhance services relating to preoperative education, psychological care, access to healthcare professionals, peer support, and financial supports. These findings can be used to inform an enhanced care pathway for IWL.
(Central) Auditory Processing Disorder ([C]APD) is an umbrella term for children who have difficulty with listening, despite normal hearing. Children with (C)APD frequently experience academic, behavioural, emotional, cognitive and social difficulties, and lack accessible, long-lasting wholistic treatments. Hence, a transdisciplinary intervention has been developed - Auditory-Cued Exercise Therapy (ACET). This manuscript details the protocol for a two-group, feasibility and preliminary effectiveness trial. Eighty participants meeting diagnostic criteria for (C)APD, aged seven to 12 years, will be quasi-randomly assigned to the ACET intervention group or a matched physical exercise-only intervention group. The intervention will consist of 8 weeks of twice-weekly 50-min exercise sessions incorporating age-appropriate activities and games to develop physical literacy. The ACET intervention will involve elements of listening practice and auditory training, using auditory cues and engagement with music and rhythm throughout exercise sessions. Improvements in auditory processing ability from baseline testing to post-intervention assessment are considered the primary outcome measure, while changes in electrophysiology, physical literacy and quality of life are secondary outcome measures. Feasibility will be reported in line with the CONSORT extension recommendations for pilot and feasibility trials. To date, no randomised control trial has evaluated ACET for this population. This paper provides important information for transparency and reproducibility of the study protocol.Trial registrationAustralia New Zealand Clinical Trials Registry; ACTRN12622001090707. Registered 8 August 2022, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=384407&isReview=true.
Healthcare workers are often associated with passionate professions and generally report high levels of compassion satisfaction. However, while passion at work plays an essential role in caring, there are two types of passion with different consequences for carers and patients. We are investigating the role of passion in this satisfaction, particularly among highly sensitive individuals. 602 female speech and language therapists anonymously answered a questionnaire. We used the Passion Scale, Compassion Satisfaction from ProQOL and the Highly Sensitive Person Scale. Results showed that 92.36% of participants reported moderate or high levels of compassion satisfaction. In terms of sensory processing sensitivity, 50.50% of participants reported high scores, whereas this generally affects around 30% of the population. Furthermore, depending on passion type, some highly sensitive participants were more prone to compassion satisfaction than others. This study highlights the need to take an interest in sensory processing sensitivity and passion in the workplace, particularly in healthcare professions, as both play a role in compassion satisfaction. It is discussed how sensitivity can be a strength in their profession and protect them from some of the negative effects of their work.
Public appropriateness or acceptability of the prosocial (or 'healthy') teasing of individuals who stutter, and other teasing-related reactions were investigated in two widely divergent cultures. Participants from the United States (USA) (n = 117) and Iran (n = 101) rated English or Persian versions of items related to the teasing of stuttering selected from a well-known attitude measure that had been adapted to compare the attitudes of males with those of females who stutter. Judgments of the acceptability of healthy teasing of hypothetical males or females who stutter were compared to teasing-related ratings, notably, imitating stuttering, filling in words, making jokes, and advising a speaker to 'Slow down' or 'Relax.' Additionally, acceptability of healthy teasing of stuttering was compared to such teasing of males or females who are intelligent, left handed, obese, or mentally ill. The attitudes toward teasing-related reactions varied by country. Although none of the teasing-related items were considered acceptable by large majorities of both countries, USA respondents generally reported greater acceptability. The respondents in both countries were more likely to reject healthy teasing for stuttering than for other attributes, such as obesity. Making jokes about - or imitating - stuttering was widely considered unacceptable by nearly all the participants. Additionally, male- versus female-related differences showed that teasing males who stutter was generally perceived as more acceptable than teasing females. Prosocial teasing is generally not regarded as appropriate for individuals who stutter in two widely divergent cultures, although a significant minority, approximately one person in five, in both the USA and Iran believe that such teasing is acceptable.
Speech-Language Pathologists (SLPs) are critical partners in transition planning for autistic young adults who prepare for independent adult life and plan to enter the workforce. Attitudes toward autistic co-workers and employees likely influence hiring decisions and job satisfaction, and, so, assessing these attitudes early in the transition process would help SLPs fine tune their interventions. To fill this need, we created and validated an assessment tool to evaluate the public's attitudes toward people on the autism spectrum who are currently competitively employed. We adapted Findler et al.'s (2007) Multidimensional Attitudes Scale Toward Persons with Disabilities to create an online survey that was completed-via a crowdsourcing platform-by 814 English-speaking adults. The data were split in half for exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). We also examined concurrent validity with Yuker et al.'s (1970) Attitudes Towards Persons with Disabilities Scale. The EFA identified six-factors (explaining together 63% of the variance) labeled: Negative Emotions, Negative Thoughts, Strategic/Managerial Skills, Avoidant Behaviors, Task-Oriented Skills, and Calm. The CFA indicated a good fit. Cronbach's alpha values for both the EFA and the CFA indicated good reliability. Concurrent validity with the ATDP was significant for all factors except Calm. The MAS-CE-ASD is a reliable assessment for identifying attitudes toward competitively employed autistic adults in the workplace. SLPs and related professionals can use this assessment to better prepare and plan transitions for their clients entering the workforce.
It may be surprising that even in recent years, the evaluation of voice function before and after treatment in patients with cleft palate has often been limited to the statistical analysis of formant frequencies, shimmer, and jitter. This reductionist approach fails to account for the complexity of voice function within an n-dimensional manifold. This review aims to address the methodology problems found in the literature and develop a comprehensive voice function assessment tool by extending the guideline of the European Laryngological Society for assessing the effect of rapid palatal expansion on voice function in patients with cleft. The scoping review was conducted according to the PRISMA guidelines, with the following research topic: 'How is vocal function assessed before and after rapid maxillary expansion in patients with operated cleft lip and palate?'. Based on the final stage of the study selection process, only two studies were included in the review. The key differences between them involved age groups, expander types, the focus on nasalance, subjective ratings, and the presence of a well-structured classification based on hearing impairment. The basics of comprehensive voice function analysis before and after rapid palatal expansion in patients with cleft-especially when glottic-level issues are present-must start somewhere, and this is the first step: Everything is in everything.
The Autism Spectrum Screening Questionnaire (ASSQ) (Ehlers & Gillberg, 1993) is a widely used tool for identifying the characteristics of autism spectrum disorder (ASD). With the increasing prevalence of ASD in Kerala, there was a need to identify and culturally validate the most appropriate tool to screen for ASD. This study aimed to translate, adapt, and validate the ASSQ into Malayalam (ASSQ-M) to improve the accuracy of ASD screening in Malayalam-speaking populations. The ASSQ-M was systematically translated, adapted, and tested for reliability and validity. The findings demonstrated strong internal consistency, with median scores and cutoff values aligning with previous adaptations in other languages. The successful validation of the ASSQ-M ensures its effectiveness as a culturally appropriate tool for ASD identification in children across a wide age range. Therefore, ASSQ-M can be effectively used by speech-language pathologists, parents, and other healthcare professionals to facilitate the identification of ASD in schools and community settings, ensuring better accessibility and screening accuracy in Kerala.
