Purpose: Unexpected life events, such as a brain injury, can result in a disrupted sense of purpose and meaning in life. Meaning and purpose in life have been identified as potentially modifiable protective factors in promoting health and well-being. At present, meaning and purpose are not widely assessed in allied health research or clinical practice, nor have measures of these constructs been validated for use after brain injury. Consideration of meaning and purpose in brain injury management may improve long-term outcomes of rehabilitation. To support assessment of meaning and purpose in rehabilitation, we examined the psychometric properties of the Meaning in Life Questionnaire–Presence of Meaning (MLQ-P) subscale in adults with a history of mild traumatic brain injury (mTBI). Method: Sixty-two people with mTBI completed the Meaning in Life Questionnaire, the Life Engagement Test, the Work and Social Adjustment Scale, and the Purpose Status Question. We evaluated the five-item MLQ-P subscale for (a) construct validity and internal structure using exploratory and confirmatory factor analysis, (b) convergent validity by examining relationships between MLQ-P and related constructs, and (c) internal consistency reliability using Cronbach's alpha. Results: The MLQ-P's internal structure was unidimensional, consistent with previous findings in the general population. Scores on the MLQ-P were strongly correlated to the Life Engagement Test, a related measure of purpose in life. The MLQ-P demonstrated strong internal consistency reliability. Conclusions: The MLQ-P is a valid measure of meaning and purpose in adults with mTBI. Future work should incorporate consideration of meaning and purpose into research and clinical practice for mTBI management.
Purpose: This qualitative study investigated social representations of cultural responsiveness related to sexual and gender diversity among speech-language pathologists (SLPs) and students in francophone contexts, focusing on metropolitan France and Quebec (Canada). Method: An online survey was conducted in 2022–2023 and yielded free-text responses from 267 participants. Responses were analyzed thematically for a rich empirical account of social representations. Results: Respondents collectively grappled with: (a) the role of SLPs in relation to sexual and gender diversity; (b) the priority to be given to addressing this diversity; (c) the consequences of current and alternate practices; and (d) the reasonableness, feasibility, and attractiveness of change. They produced representations ranging from status quo–preserving views to innovative visions for the field. These representations played out in practice through a wide array of challenges navigated by respondents with varied strategies and resources. To move forward, respondents called for training opportunities, accessible information, appropriate clinical tools, and organizational commitment backed by funding and time. Conclusions: Although transgender voice modification dominates representations related to sexual and gender diversity in the field, cultural responsiveness extends across subfields and much of the SLP's scope of practice. Importantly, SLPs and students are not immune to unconscious biases and ideologies even on topics within their expertise, such as language. Many respondents upheld, for instance, popular but largely unsubstantiated representations of gender-inclusive written French as detrimental to “readability.” These findings thus point to education as a key lever for cultural responsiveness, along with organizational commitment and resource provision.
Purpose: Patients with severe acquired brain injury and disorders of consciousness (DoC) are noncommunicative and present with severe dysphagia. To characterize current practices, identify gaps, and explore emerging approaches in postcomatose rehabilitation, the DoC Special Interest Group of the International Brain Injury Association conducted an international survey on speech-language therapy (SLT) practices. Method: An online questionnaire, available in seven languages, was disseminated to clinicians involved in swallowing and/or language and communication rehabilitation of patients with DoC. The survey captured (a) sociodemographic and practice setting information, (b) general postcomatose SLT practices, (c) swallowing assessment and management, and (d) language and communication assessment and management. Results: Responses were obtained from 166 clinicians, predominantly speech-language pathologists (74%), working in acute/subacute care (38%) or in longer-term rehabilitation (71%). Most assessed (74%) and managed (74%) swallowing disorders, and 25% created or adapted their own assessment tools. For language and communication, most respondents reported assessing (82%) and managing (76%) these abilities, with frequent use of augmentative and alternative communication (71%). Family input was considered central, for identifying motivating stimuli (96%) and involving relatives in therapy (87%). While 29% developed their own language assessment tools, 51% did so for intervention tools, reflecting limited validated resources. Conclusions: Clinicians worldwide assess and manage swallowing and communication in patients with DoC but report a lack of validated tools. Practice often relies on individualized approaches and clinician-developed materials, with family involvement. These findings highlight the need for enhanced training and standardized, evidence-based instruments to strengthen SLT practices across the continuum of care. Supplemental Material: https://doi.org/10.23641/asha.34741404
Purpose: The aim of this study was to better understand the functional implications of late talking by documenting the lived experiences of parenting a late-talking toddler. Method: All parents had previously enrolled their children in a vocabulary intervention study with the authors when their children were toddlers. We created interview questions collaboratively with a focus group of these parents. We then individually interviewed 10 parents of late talkers. Two coders engaged in consensus coding, using an inductive, qualitative content analysis process to develop categories. During the coding process, codes were organized under three major topic areas: (a) support for the child and family, (b) parents' perceptions of their child's communication, and (c) how having a late talker influenced relationship dynamics within the family. Results: We developed six primary categories to summarize the parents' responses: (a) barriers to support, (b) facilitators to support, (c) parents' suggestions for support systems, (d) child-specific characteristics, (e) child–parent experiences, and (f) within-family roles and relationships. Conclusion: Findings are contextualized in terms of action items to better support families of children with late talkers, including improving support for families, attending to family relationship dynamics, academic applications and considerations, and encouragement for families. Supplemental Material: https://doi.org/10.23641/asha.34556325
Purpose: This study provided an initial exploration of Iranian speech-language pathologists' (SLPs') treatment priorities, reported intervention approaches, and perceived clinical challenges for stuttering across the lifespan. Method: Seventy-four Iranian SLPs completed a Farsi online survey ranking three treatment aspects aligned with the World Health Organization's International Classification of Functioning, Disability and Health—overt stuttering behaviors, reactions to stuttering, and communication participation—across preschool, school-age/adolescent, and adult clients. They also rated intervention use frequency and described clinical challenges. Quantitative data were analyzed using nonparametric tests, qualitative responses were analyzed using reflexive thematic analysis, and exploratory mixed-methods integration linked clinician priority profiles to qualitative themes. Results: Across all three age groups, clinicians ranked overt behaviors highest, reactions intermediate, and communication participation lowest. This hierarchy did not shift meaningfully across age groups and was not associated with education or clinical experience. Qualitative themes highlighted pressure for fluency, relapse, acceptance, generalization difficulties, emotional burden, and clinician uncertainty. Exploratory participant-level integration showed that clinicians with stronger fluency-anchored profiles appeared less likely to describe challenges related to relapse, generalization, and pressure for fluency. Conclusions: In this initial sample, clinicians' self-reported priorities remained strongly oriented toward overt speech behaviors despite contemporary multidimensional models of stuttering. Findings should be regarded as exploratory and as a basis for larger replication studies. Findings highlight the need for training and service models that more explicitly integrate participation, counseling-informed support, and stigma-responsive care across the lifespan.
