'Am I a good enough therapist?': Self-doubt among speech and language therapists.

BACKGROUND: The therapeutic process is fraught with various feelings. This research focused on a specific type of negative feeling, namely self-doubt (SD). AIM: To explore and characterize the nature of SD among speech and language therapists (SLTs) (the frequency of SD, situations that trigger SD, emotions and thoughts related to SD, and coping strategies) in various stages of occupational experience. METHODS & PROCEDURES: A total of 267 SLTs answered an online survey. Respondents represented SLTs in all stages of vocational experience, with varying academic degrees, from a variety of employment settings. The survey addressed situations that trigger SD, thoughts, and emotions associated with SD and the background information of the respondents. Frequency distributions of the responses of the participants were determined, and independent-samples Kruskal-Wallis tests were conducted to examine if there were differences between groups that differed in their occupational experience on the frequency of SD, attitudes towards SD and emotions related to SD. OUTCOMES & RESULTS: Differences were found between SLTs in various stages of professional development in several aspects of SD. Novice SLTs reported significantly higher levels of SD compared with experienced SLTs. In the face of SD, novice SLTs consider career abandonment significantly more than do experienced SLTs. They perceive themselves as a failure when experiencing SD to a significantly greater extent than do more experienced SLTs. In addition, SD is associated with various negative emotions. CONCLUSIONS & IMPLICATIONS: Self-doubt is a natural professional feeling. It may be harmful especially in the early stages of professional development. Our findings call for support and guidance in the face of SD. WHAT THIS PAPER ADDS: What is already known on the subject Healthcare professionals report feeling SD. This feeling may have deleterious effects on well-being and career satisfaction and is especially harmful in young therapists. What this paper adds to existing knowledge This study characterizes the nature of SD among SLTs in various stages of occupational experience. Our findings indicate that SD is reported among SLTs at all career stages, especially in novice SLTs. Self-doubt is associated with a range of negative thoughts and emotions, and it may be triggered by various situations. Nonetheless, it is a topic that our respondents rarely learn about. What are the potential or actual clinical implications of this work? Normalising and validating SD is important to SLTs' resilience and may facilitate coping. This may be achieved by learning about the subject of SD in graduate programmes. In addition, mentors should create a safe learning culture to allow sharing SD and challenging situations, especially in the first years of occupational experience.

The Bouba-Kiki Effect in Children With Childhood Apraxia of Speech.

PURPOSE: The bouba-kiki (BK) effect refers to associations between visual shapes and auditory pseudonames. Thus, when tested, people tend to associate the pseudowords bouba and kiki with round or spiky shapes, respectively. This association requires cross-modal sensory integration. The ability to integrate information from different sensory modalities is crucial for speech development. A clinical population that may be impaired in cross-modal sensory integration is children with childhood apraxia of speech (CAS). The purpose of this study was to examine the involvement of cross-modal sensory integration in children with (CAS). METHOD: The BK effect was assessed in participants with CAS (n = 18) and two control groups: One control group was composed of children with developmental language disorder (DLD), also termed specific language impairment (n = 15), and a second group included typically developing (TD) children (n = 22). The children were presented with 14 pairs of novel visual displays and nonwords. All the children were asked to state which shape and nonword correspond to one another. In addition, background cognitive (Leiter-3) and language measures (Hebrew PLS-4) were determined for all children. RESULTS: Children in the CAS group were less successful in associating between visual shapes and corresponding auditory pseudonames (e.g., associating the spoken word "bouba" with a round shape; the spoken word "kiki" with a spiky shape). Thus, children with CAS demonstrated a statistically significant reduced BK effect compared with participants with TD and participants with DLD. No significant difference was found between the TD group and the DLD group. CONCLUSIONS: The reduced BK effect in children with CAS supports the notion that cross-modal sensory integration may be altered in these children. Cross-modal sensory integration is the basis for speech production. Thus, difficulties in sensory integration may contribute to speech difficulties in CAS.

The experience of speech-language therapists and audiologists when delivering bad news: A qualitative analysis.

BACKGROUND: As part of their professional responsibilities, speech-language therapists and audiologists are required to deliver bad news. AIMS: The aim of this qualitative study is to describe and characterize the subjective experience of speech-language therapists and audiologists when delivering bad news to clients or their family members. METHODS & PROCEDURES: A group of 156 speech-language therapists and audiologists replied in writing to an open question asking them to describe a clinical encounter in which they delivered bad news. The texts that were generated in response to this question served as a data base. Qualitative content analysis was used to analyse data and generate themes. OUTCOMES & RESULTS: Thematic analysis of participants' texts revealed the challenges inherent to the delivery of bad news. Four main themes emerged from text analysis: difficulty in phrasing the news; the deliverer's emotional experience; the receiver's reaction; and being alone or in companion with another healthcare provider during the delivery of the bad news. CONCLUSIONS & IMPLICATIONS: Speech-language therapists and audiologists experience difficulties similar to those experienced by other healthcare professionals when delivering bad news. Nevertheless, speech-language therapists and audiologists seem to perceive the delivery of bad news situation in a broader sense than the conventional definition given to this term in the medical arena. What this paper adds What is already known on the subject The task of delivering bad news is stressful to healthcare professionals. Most of the literature on the topic pertains to physicians. Little is known regarding the delivery of bad news in speech-language therapy and audiology. What this paper adds to existing knowledge This study highlights the challenges that speech-language therapists and audiologists encounter when delivering bad news. Furthermore, it illuminates the implicit perceptions of these professionals regarding what is considered 'bad news'. What are the potential or actual clinical implications of this work? The emotional challenges associated with the delivery of bad news underscore the importance of support and training regarding the delivery of bad news. It is especially important to prepare for a client's difficult questions, and to prefer a collaborative approach to the delivery of bad news.

Metaphor Comprehension in Low and High Creative Individuals.

The comprehension of metaphors involves the ability to activate a broader, more flexible set of semantic associations in order to integrate the meanings of the weakly related parts of the metaphor into a meaningful linguistic expression. Previous findings point to a relation between levels of creativity and efficiency in processing metaphoric expressions, as measured by reaction times (RTs) and error rates. Furthermore, recent studies have found that more creative individuals exhibit a relatively more flexible semantic memory structure compared to less creative individuals, which may facilitate their comprehension of novel metaphors. In the present study, lower and higher creative individuals performed a semantic relatedness judgment task on word pairs. These word pairs comprised four types of semantic relations: novel metaphors, conventional metaphors, literal word pairs, and meaningless word pairs. We hypothesized that the two groups will perform similarly in comprehending the literal, unrelated, and the conventional metaphoric word pairs. However, with respect to novel metaphors, we predicted that higher creative individuals will demonstrate better performance compared to lower creative individuals, as indicated by smaller RTs and more accurate responses. Our main finding shows that higher creative individuals were faster in comprehending both types of metaphors, conventional and novel, compared to lower creative individuals. Furthermore, higher creative individuals were significantly more accurate than lower creative individual only in comprehending novel metaphors. The findings are discussed in light of previous findings regarding the relation between metaphor comprehension, semantic memory, and creativity.

Delivering Bad News: Attitudes, Feelings, and Practice Characteristics Among Speech-Language Pathologists.

Purpose: The purpose of this study was to examine the attitudes, feelings, and practice characteristics of speech-language pathologists (SLPs) in Israel regarding the subject of delivering bad news. Method: One hundred and seventy-three Israeli SLPs answered an online survey. Respondents represented SLPs in Israel in all stages of vocational experience, with varying academic degrees, from a variety of employment settings. The survey addressed emotions involved in the process of delivering bad news, training on this subject, and background information of the respondents. Frequency distributions of the responses of the participants were determined, and Pearson correlations were computed to determine the relation between years of occupational experience and the following variables: frequency of delivering bad news, opinions regarding training, and emotions experienced during the process of bad news delivery. Results: Our survey showed that bad news delivery is a task that most participants are confronted with from the very beginning of their careers. Participants regarded training in the subject of delivering bad news as important but, at the same time, reported receiving relatively little training on this subject. In addition, our survey showed that negative emotions are involved in the process of delivering bad news. Conclusions: Training SLPs on specific techniques is required for successfully delivering bad news. The emotional burden associated with breaking bad news in the field of speech-language pathology should be noticed and addressed.

The bouba-kiki effect and its relation to the Autism Quotient (AQ) in autistic adolescents.

The bouba-kiki effect refers to the correspondence between arbitrary visual and auditory stimuli. Previous studies indicate ASD persons' reduced bouba-kiki effect compared to controls. This study examines the relation between ASD symptomology and performance on the bouba-kiki task. Twenty ASD participants and 20 matched controls were presented the bouba-kiki task. Autism-Quotient (AQ) scores and several cognitive measures were obtained for all participants. Results demonstrate that among all measures, only AQ scores were significantly correlated to the performance on the bouba-kiki task in the ASD group. Results thus support the existence of a relation between autism symptoms and performance on the bouba-kiki task, and are discussed in light of current theories.

The Hyper-Modular Associative Mind: A Computational Analysis of Associative Responses of Persons with Asperger Syndrome.

Rigidity of thought is considered a main characteristic of persons with Asperger syndrome (AS). This rigidity may explain the poor comprehension of unusual semantic relations, frequently exhibited by persons with AS. Research indicates that such deficiency is related to altered mental lexicon organization, but has never been directly examined. The present study used computational network science tools to compare the mental lexicon structure of persons with AS and matched controls. Persons with AS and matched controls generated free associations, and network tools were used to extract and compare the mental lexicon structure of the two groups. The analysis revealed that persons with AS exhibit a hyper-modular semantic organization: their mental lexicon is more compartmentalized compared to matched controls. We argue that this hyper-modularity may be related to the rigidity of thought which characterizes persons with AS and discuss the clinical and more general cognitive implications of our findings.

Metaphors and verbal creativity: the role of the right hemisphere.

Ample research suggests that the right cerebral hemisphere plays a central role in verbal creativity as well as in novel metaphor comprehension. The aim of the present study was to directly examine the relation between verbal creativity and right hemisphere involvement during novel metaphor comprehension. Thus 30 healthy adults were asked to fill in the Hebrew version of the Remote Association Test to assess their level of creativity. In addition, reaction times and error rates were measured while these participants performed a semantic judgement task on two word expressions presented in a divided visual field paradigm. The word pairs comprised four types of semantic relations: novel metaphors, conventional metaphors, literal word pairs, and meaningless word pairs. Correlations were conducted to assess the relation between level of creativity and processing of the four pair types in the two cerebral hemispheres. The main finding was of a significant negative correlation between degree of creativity and reaction times to novel metaphor processing in the right hemisphere, thus supporting the involvement of this cerebral hemisphere in both tasks. Results are discussed in light of linguistic theories and recent neuroscientific evidence regarding relative hemispheric involvement during semantic processing.

Auditory emotion recognition impairments in schizophrenia: relationship to acoustic features and cognition.

OBJECTIVE: Schizophrenia is associated with deficits in the ability to perceive emotion based on tone of voice. The basis for this deficit remains unclear, however, and relevant assessment batteries remain limited. The authors evaluated performance in schizophrenia on a novel voice emotion recognition battery with well-characterized physical features, relative to impairments in more general emotional and cognitive functioning. METHOD: The authors studied a primary sample of 92 patients and 73 comparison subjects. Stimuli were characterized according to both intended emotion and acoustic features (e.g., pitch, intensity) that contributed to the emotional percept. Parallel measures of visual emotion recognition, pitch perception, general cognition, and overall outcome were obtained. More limited measures were obtained in an independent replication sample of 36 patients, 31 age-matched comparison subjects, and 188 general comparison subjects. RESULTS: Patients showed statistically significant large-effect-size deficits in voice emotion recognition (d=1.1) and were preferentially impaired in recognition of emotion based on pitch features but not intensity features. Emotion recognition deficits were significantly correlated with pitch perception impairments both across (r=0.56) and within (r=0.47) groups. Path analysis showed both sensory-specific and general cognitive contributions to auditory emotion recognition deficits in schizophrenia. Similar patterns of results were observed in the replication sample. CONCLUSIONS: The results demonstrate that patients with schizophrenia show a significant deficit in the ability to recognize emotion based on tone of voice and that this deficit is related to impairment in detecting the underlying acoustic features, such as change in pitch, required for auditory emotion recognition. This study provides tools for, and highlights the need for, greater attention to physical features of stimuli used in studying social cognition in neuropsychiatric disorders.

Semantic integration during metaphor comprehension in Asperger syndrome.

Previous research indicates severe disabilities in processing figurative language in people diagnosed on the autism spectrum disorders. However, this aspect of language comprehension in Asperger syndrome (AS) specifically has rarely been the subject of formal study. The present study aimed to examine the possibility that in addition to their pragmatic deficits, the difficulties in the comprehension of metaphors in AS may be explained by deficient linguistic information processing. Specifically, we aimed to examine whether a deficient semantic integration process underlies the difficulties in metaphor comprehension frequently experienced by persons with AS. The semantic integration process of sixteen AS participants and sixteen matched controls was examined using event related potentials (ERPs). N400 amplitude served as an index for degree of effort invested in the semantic integration process of two-word expressions denoting literal, conventional metaphoric, and novel metaphoric meaning, as well as unrelated word pairs. Large N400 amplitudes for both novel and conventional metaphors demonstrated the greater difficulties in metaphor comprehension in the AS participants as compared to controls. Findings suggest that differences in linguistic information processing cause difficulties in metaphor comprehension in AS.

Right hemisphere dysfunction and metaphor comprehension in young adults with Asperger syndrome.

This study examined whether the known difficulties in metaphor comprehension exhibited by persons with Asperger syndrome (AS) can be explained by a dysfunctional right hemisphere (RH). Using the divided visual field paradigm, 27 AS participants and 36 matched controls were presented with word pairs of four types (literal, conventional metaphors, novel metaphors, and unrelated word pairs), and were asked to perform a semantic judgment task. The main hypothesis was that whereas the control group participants will show RH superiority for novel metaphor processing, no RH superiority will be found in the AS group. Results indeed indicate much less RH contribution to novel metaphor comprehension in AS, and are discussed in light of linguistic models and the neurobiology of autism.