Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 4.066
Filtrar
Mais filtros








Intervalo de ano de publicação
1.
Codas ; 36(4): e20230233, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38775527

RESUMO

PURPOSE: Prospective memory (PM) questionnaires are frequently used to evaluate perceptions of PM skills in daily life. This study aimed to systematically investigate communication-specific attributes using pre-existing PM self-rating questionnaires to inform clinicians and researchers about the role of PM in cognitive communicative evaluations. METHODS: PM-related items from three questionnaires (i.e., Prospective Memory Questionnaire, Comprehensive Assessment of Prospective Memory, and Prospective and Retrospective Memory Questionnaire) were compiled and embedded in Google Forms and distributed to 70 Speech-Language Pathologists (SLPs) with expertise in Cognitive Communicative Disorders across India. Participants first identified items related to communication, and were then contacted to rate the communication-related PM items using a Likert scale for their degree of appropriateness. Responses from 40 SLPs were obtained and subjected to item-content validity index (i-CVI) and exploratory factor analysis (EFA). RESULTS: Of the 114 PM items, 28 received ratings over 50% for their relevance to communication. Of the 28 items, 21 had an i-CVI score greater than 0.8. After the removal of overlapping content, 14 items were finalized and subjected to EFA, which resulted in four factors: PM failure due to loss of communicative content, PM failure due to loss of communicative intent, PM cost due to ongoing interference, and PM failure linked to the priority of communicative intent. CONCLUSION: This study highlights communication-related aspects of PM that can be used as a framework for SLPs to assess and research PM skills.


Assuntos
Comunicação , Memória Episódica , Patologia da Fala e Linguagem , Humanos , Inquéritos e Questionários , Análise Fatorial , Índia , Feminino , Masculino , Reprodutibilidade dos Testes , Adulto , Psicometria , Transtornos da Comunicação
4.
Am J Speech Lang Pathol ; 33(3): 1456-1470, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38557150

RESUMO

PURPOSE: International cleft lip and palate surgical charities recognize that speech therapy is essential for successful care of individuals after palate repair. The challenge is how to ensure that cleft speech interventionists (i.e., speech-language pathologists and other speech therapy providers) provide quality care. This exploratory study investigated effects of a two-stage cleft training in Oaxaca, Mexico, aimed at preparing speech interventionists to provide research-based services to individuals born with cleft palate. Changes in the interventionists' content knowledge and clinical skills were examined. METHOD: Twenty-three cleft speech interventionists from Mexico, Guatemala, and Nicaragua participated in a hybrid two-stage training, completing an online Spanish cleft speech course and a 5-day in-person training in Oaxaca. In-person training included a didactic component and supervised clinical practice with 14 individuals with repaired cleft palates. Testing of interventionists' content knowledge and clinical skills via questionnaires occurred before the online course (Test 1), immediately before in-person training (Test 2), and immediately after in-person training (Test 3). Qualitative data on experience/practice were also collected. RESULTS: Significant increases in interventionists' overall content knowledge and clinical skills were found posttraining. Knowledge and clinical skills increased significantly between Tests 1 and 2. Clinical skills, but not knowledge, showed further significant increases between Tests 2 and 3. Posttraining, interventionists demonstrated greater expertise in research-based treatment, and fewer reported they would use nonspeech oral motor exercises (NSOME). CONCLUSIONS: Findings provide preliminary support for such two-stage international trainings in preparing local speech interventionists to deliver high-quality speech services to individuals born with cleft palate. While content knowledge appears to be acquired primarily from the online course, the two-stage training incorporating in-person supervised practice working with individuals born with cleft palate may best enhance continued clinical skill development, including replacement of NSOME with evidence-based speech treatment. Such trainings contribute to building capacity for sustainable quality services for this population in underresourced regions.


Assuntos
Fissura Palatina , Competência Clínica , Fonoterapia , Patologia da Fala e Linguagem , Humanos , Fissura Palatina/terapia , México , Patologia da Fala e Linguagem/educação , Fonoterapia/educação , Fonoterapia/métodos , Masculino , Feminino , Currículo , Adulto , Nicarágua , Conhecimentos, Atitudes e Prática em Saúde
5.
Lang Speech Hear Serv Sch ; 55(2): 423-433, 2024 04 11.
Artigo em Inglês | MEDLINE | ID: mdl-38557245

RESUMO

PURPOSE: This article addresses considerations for the speech-language pathologist to ensure culturally competent dysphagia management in the school setting for children with oral motor, swallowing, and pediatric feeding disorders (PFDs). There is also discussion of the multifactorial cultural and linguistic influences that impact collaborative educational decisions when establishing and implementing school-based dysphagia services. CONCLUSIONS: The consideration of cultural and linguistic factors for the child with oral motor, swallowing, and/or PFDs is essential when diagnosing, treating, and planning for dysphagia service delivery. By recognizing and including culturally appropriate interventions and recommendations, speech-language pathologists enhance opportunities for positive outcomes and treatment efficacy when providing pediatric dysphagia services in the educational setting for children from culturally and linguistically diverse backgrounds.


Assuntos
Transtornos da Comunicação , Transtornos de Deglutição , Transtornos da Alimentação e da Ingestão de Alimentos , Patologia da Fala e Linguagem , Criança , Humanos , Transtornos de Deglutição/diagnóstico , Transtornos de Deglutição/terapia , Idioma , Linguística
6.
Lang Speech Hear Serv Sch ; 55(2): 389-393, 2024 04 11.
Artigo em Inglês | MEDLINE | ID: mdl-38563740

RESUMO

PURPOSE: This prologue introduces the forum "Pediatric Feeding Disorder and the School-Based SLP: An Evidence-Based Update for Clinical Practice" and informs the reader of the scope of articles presented. METHOD: The guest prologue author provides a brief history of pediatric feeding and swallowing services in the public-school setting, including previous forums on swallowing and feeding services in the schools (Logemann & O'Toole, 2000; McNeilly & Sheppard, 2008). The concepts that have been learned since the 2008 forum are shared. The contributing authors in the forum are introduced, and a summary is provided for each of the articles. CONCLUSIONS: The articles provide evidence-based information on topics that are uniquely of interest to school-based speech-language pathologists managing pediatric feeding and swallowing in their districts. The topics shared in this forum range from relevant information on anatomy, physiology, developmental milestones, and differential diagnosis to therapeutic practice when identifying and treating pediatric feeding and swallowing in the school setting. The forum also includes focused articles on the necessity of collaboration with families during the treatment process, current information on legal parameters dealing with school-based pediatric feeding disorder services, and a framework for assessment and treating pediatric feeding disorder in the school setting.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos , Patologia da Fala e Linguagem , Humanos , Criança , Patologistas , Fala , Idioma , Aprendizagem , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Transtornos da Alimentação e da Ingestão de Alimentos/terapia
7.
Patient Educ Couns ; 124: 108250, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38503035

RESUMO

OBJECTIVE: The study aimed to explore facilitators and barriers in delivering person-centered care from the perspective of speech-language pathologists and audiologists in a socio- economically diverse workplace across micro, meso, and macro levels. METHOD: A national cross-sectional e-survey was conducted among pooled speech-language pathologists and/or audiologists from South Africa. The e-survey included quantitative components to describe participant demographics which was analysed using descriptive and inferential statistics. The qualitative data was analyzed using metaphor and thematic analysis approaches to describe respondents' perspectives of barriers and facilitators in delivering person-centered care. RESULTS: The e-survey was completed by 63 clinicians (36.5% Audiologists; 36.5% Speech-Language Therapists; 27.0% dually qualified Speech-Language Therapists and Audiologists) mostly between the ages of 26 to 35 years old (33.3%). Respondents were working in various settings including the public sector (41.3%), private sector (44.4%) and in academia (14.3%). Facilitators and barriers were identified within all three systems (macro, meso and micro). The metaphor analysis resulted in six categories: uncertainty of Person centered care; its essential nature; associated challenges; relational aspect; analogies referring to animals; and food-related analogies. Thematic analysis of open-ended questions revealed five barriers, with three relating to micro systems; i) clinician factors, ii) client factors, iii) clinician and client interaction, and two related to factors within the meso system; iv) resources, and v) workplace. Only two themes were identified as facilitators towards PCC, clinician factors (mirco) and workplace factors (meso).' CONCLUSIONS: Insights gained from exploring Speech-Language Pathologists' and Audiologists' perceptions of implementing PCC in a socio-economically diverse setting highlight the need to address contextual (meso and macro systems) and personal (micro system) factors to promote and deliver PCC effectively. Notably, for the public sector, resources emerged as a major concern and barrier on the macro system level. Despite these challenges, the investigation revealed two noteworthy facilitators: clinician factors, at the micro level, and workplace factors, at the meso level. This nuanced understanding emphasizes the necessity of tailored interventions targeting both individual and systemic aspects to enhance the successful implementation of person-centered care. PRACTICAL IMPLICATIONS: Strategies should focus on enhancing clinicians' communication skills, collaboration, and teamwork, as well as addressing resource limitations through the adaptation of tools and implementation of PCC ISO standards.


Assuntos
Audiologistas , Assistência Centrada no Paciente , Patologia da Fala e Linguagem , Humanos , Adulto , Feminino , Estudos Transversais , Masculino , África do Sul , Inquéritos e Questionários , Atitude do Pessoal de Saúde , Pesquisa Qualitativa , Pessoa de Meia-Idade , Local de Trabalho/psicologia
8.
Am J Speech Lang Pathol ; 33(3): 1113-1126, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38501906

RESUMO

PURPOSE: The study of gender and speech has historically excluded studies of transmasculine individuals. Consequently, generalizations about speech and gender are based on cisgender individuals. This lack of representation hinders clinical training and clinical service delivery, particularly by speech-language pathologists providing gender-affirming communication services. This letter describes a new corpus of the speech of American English-speaking transmasculine men, transmasculine nonbinary people, and cisgender men that is open and available to clinicians and researchers. METHOD: Twenty masculine-presenting native English speakers from the Upper Midwestern United States (including cisgender men, transmasculine men, and transmasculine nonbinary people) were recorded, producing three sets of speech materials: Consensus Auditory-Perceptual Evaluation of Voice sentences, the Rainbow Passage, and a novel set of sentences developed for this project. Acoustic measures vowels (overall formant frequency scaling, vowel-space dispersion, fundamental frequency, breathiness), consonants (voice onset time of word-initial voiceless stops, spectral moments of word-initial /s/), and the entire sentence (rate of speech) that were made. RESULTS: The acoustic measures reveal a wide range for all dependent measures and low correlations among the measures. Results show that many of the voices depart considerably from the norms for men's speech in published studies. CONCLUSION: This new corpus can be used to illustrate different ways of sounding masculine by speech-language pathologists performing gender-affirming communication services and by higher education teachers as examples of diverse ways of sounding masculine.


Assuntos
Acústica da Fala , Medida da Produção da Fala , Pessoas Transgênero , Qualidade da Voz , Humanos , Masculino , Pessoas Transgênero/psicologia , Adulto , Adulto Jovem , Patologia da Fala e Linguagem/métodos , Feminino , Pessoa de Meia-Idade , Fonética
9.
Am J Speech Lang Pathol ; 33(3): 1485-1503, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38512040

RESUMO

PURPOSE: Motor deficits are widely documented among autistic individuals, and speech characteristics consistent with a motor speech disorder have been reported in prior literature. We conducted an auditory-perceptual analysis of speech production skills in low and minimally verbal autistic individuals as a step toward clarifying the nature of speech production impairments in this population and the potential link between oromotor functioning and language development. METHOD: Fifty-four low or minimally verbal autistic individuals aged 4-18 years were video-recorded performing nonspeech oromotor tasks and producing phonemes, syllables, and words in imitation. Three trained speech-language pathologists provided auditory perceptual ratings of 11 speech features reflecting speech subsystem performance and overall speech production ability. The presence, attributes, and severity of signs of oromotor dysfunction were analyzed, as were relative performance on nonspeech and speech tasks and correlations between perceptual speech features and language skills. RESULTS AND CONCLUSIONS: Our findings provide evidence of a motor speech disorder in this population, characterized by perceptual speech features including reduced intelligibility, decreased consonant and vowel precision, and impairments of speech coordination and consistency. Speech deficits were more associated with articulation than with other speech subsystems. Speech production was more impaired than nonspeech oromotor abilities in a subgroup of the sample. Oromotor deficits were significantly associated with expressive and receptive language skills. Findings are interpreted in the context of known characteristics of the pediatric motor speech disorders childhood apraxia of speech and childhood dysarthria. These results, if replicated in future studies, have significant potential to improve the early detection of language impairments, inform the development of speech and language interventions, and aid in the identification of neurobiological mechanisms influencing communication development.


Assuntos
Inteligibilidade da Fala , Humanos , Criança , Pré-Escolar , Masculino , Adolescente , Feminino , Percepção da Fala , Medida da Produção da Fala , Transtorno Autístico/psicologia , Transtorno Autístico/complicações , Transtorno Autístico/diagnóstico , Gravação em Vídeo , Distúrbios da Fala/diagnóstico , Distúrbios da Fala/fisiopatologia , Patologia da Fala e Linguagem/métodos , Transtornos da Articulação/diagnóstico
10.
Am J Speech Lang Pathol ; 33(3): 1443-1455, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38446909

RESUMO

PURPOSE: Across Canada, speech-language pathologists (SLPs) and educational psychologists (EPs) work in schools to identify and diagnose childhood learning difficulties, including language disorders; however, both professional groups use different terms to identify and diagnose them. Using the term developmental language disorder (DLD), developed by the CATALISE consortium, would provide consistency across fields. To effectively implement the use of DLD, it is crucial to understand how EPs and SLPs currently identify childhood language disorders and to investigate the potential impact of a practice change in this area. METHOD: The study conducted 13 moderated focus groups and one one-on-one semistructured interview across six Canadian provinces in English and French. RESULTS: We found some social and structural barriers that impact SLPs' and EPs' current practice of identifying and diagnosing language disorders generally (e.g., the belief that children should not be labeled "too early," institutions that prioritize certain professional diagnoses over others, board policies that do not allocate funds for language disorders, professionals' reticence to convey difficult information such as a diagnosis to collaborators) and DLD specifically (e.g., different professional taxonomies, lack of familiarity with or uncertainty about the label, not recognized as a condition in schools that may or may not even identify language disorder as a category of exceptionality). Nevertheless, the focus groups also revealed the extent to which DLD could be useful in their current practice. CONCLUSION: Both EPs and SLPs acknowledged the importance of working together; therefore, DLD could inspire more collaborative practice between SLPs and EPs around language disorders.


Assuntos
Atitude do Pessoal de Saúde , Grupos Focais , Transtornos do Desenvolvimento da Linguagem , Patologia da Fala e Linguagem , Humanos , Patologia da Fala e Linguagem/educação , Canadá , Transtornos do Desenvolvimento da Linguagem/diagnóstico , Criança , Linguagem Infantil , Conhecimentos, Atitudes e Prática em Saúde , Psicologia/educação , Feminino , Masculino , Entrevistas como Assunto , Terminologia como Assunto
11.
Am J Speech Lang Pathol ; 33(3): 1524-1535, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38477644

RESUMO

PURPOSE: Speech-language pathology programs use simulated learning experiences (SLEs) to teach graduate student clinicians about fidelity to therapeutic interventions, including static skills (clinical actions that are delivered in a prespecified way regardless of the client's behavior) and dynamic skills (contingent responses formulated in response to a client's behavior). The purpose of this study was to explore student learning of static and dynamic skills throughout SLEs and live clinical practice. METHOD: Thirty-three speech-language pathology graduate students participated in this study. Students were first trained to deliver an intervention before having their treatment fidelity measured at three time points: an initial SLE, actual clinical practice, and a final SLE. Treatment fidelity was first summarized using an overall accuracy score and then separated by static and dynamic skills. We hypothesized that (a) overall accuracy would increase from the initial simulation to treatment but remain steady from treatment to the final simulation and that (b) students would acquire dynamic skills more slowly than static skills. RESULTS: In line with our hypotheses, students' overall accuracy improved over time. Although accuracy for static skills was mostly established after the first simulation, dynamic skills remained less accurate, with a slower acquisition timeline. CONCLUSIONS: These results demonstrate that SLEs are efficacious in teaching students the clinical skills needed for actual clinical practice. Furthermore, we show that dynamic skills are more difficult for students to learn and implement than static skills, which suggests the need for greater attention to dynamic skill acquisition during clinical education.


Assuntos
Competência Clínica , Educação de Pós-Graduação , Patologia da Fala e Linguagem , Humanos , Patologia da Fala e Linguagem/educação , Masculino , Feminino , Educação de Pós-Graduação/métodos , Adulto , Adulto Jovem , Estudantes de Ciências da Saúde/psicologia , Treinamento por Simulação/métodos , Fatores de Tempo
12.
Am J Speech Lang Pathol ; 33(3): 1373-1389, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38483194

RESUMO

PURPOSE: Despite the speed with which telehealth use advanced during the COVID-19 pandemic, evidence is needed to support the remote delivery of standardized assessments. This study investigated the reliability and feasibility of administering a standardized language assessment administered in real-world telehealth scenarios compared to in-person administration. METHOD: A total of 100 children between the ages of 3 and 12 years were administered one of three versions of the Clinical Evaluation of Language Fundamentals (CELF). Children were administered the CELF by the same licensed speech-language pathologists (SLPs) in person and using telehealth, with the order counterbalanced. Means for Core Language standard scores were compared between conditions and among devices. Descriptive statistics summarized the behavior and technology disruptions during administration as well as the results of parent and SLP telehealth perception surveys. RESULTS: In-person and telehealth mean scores on all three versions of the CELF revealed no systematic differences of one condition under- or overestimating another. The incidence of child behavior disruptions was similar for both test administration conditions. Adaptations compensated for the rare technology disruptions. Despite no significant language score and behavior differences between testing conditions, parents reported they continued to prefer in-person assessments. SLP participants viewed telehealth overall positively but identified conditions in which they continued to prefer in-person delivery. CONCLUSIONS: This study provides evidence of minimal or no differences in scores and behavioral or technological disruptions between remote and in-person administration of the CELF core language assessments. SLP and parent participants' attitudes toward remote delivery of standardized tests appear to be evolving in a positive direction compared to previous studies. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25292752.


Assuntos
COVID-19 , Linguagem Infantil , Estudos de Viabilidade , Testes de Linguagem , Patologia da Fala e Linguagem , Telemedicina , Humanos , Criança , Pré-Escolar , Masculino , Feminino , Telemedicina/métodos , Reprodutibilidade dos Testes , Patologia da Fala e Linguagem/métodos , SARS-CoV-2
13.
Am J Speech Lang Pathol ; 33(3): 1142-1156, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38536710

RESUMO

PURPOSE: Project Building Bridges was funded by the U.S. Department of Education Office of Special Education Programs to address the shortage of speech-language pathologists qualified to serve students with complex communication needs who benefit from augmentative and alternative communication (AAC) and are culturally and linguistically diverse. The purpose was to train future speech-language pathologists in culturally responsive AAC practices through coursework and fieldwork in AAC integrated into the Master of Science degree in Speech, Language and Hearing Sciences. METHOD: Fifty-seven graduate students completed the project. The scholars' curriculum consisted of two AAC courses, both on-campus and externship AAC clinical practicum experiences to provide services to multicultural and linguistically diverse students, a U.S. or international service-learning opportunity, and cumulative portfolio presentations. RESULTS: Mixed-methods outcome measures consisted of four sets of pre- and postsurveys and qualitative feedback from exit interviews to assess changes in graduate student competencies. Significant differences were demonstrated between scholars' pre- and post-assessments of confidence ratings. Significant differences were also demonstrated in both scholars' and school mentors' pre- and post-assessments of competency ratings. No significant differences were found between evaluations of AAC preparation by Clinical Fellowship (CF) candidates and their CF mentors at 1 year postgraduation. CONCLUSIONS: Project Building Bridges provides a framework for preparing highly qualified speech-language pathologists to serve culturally and linguistically diverse students who benefit from AAC as evidenced by pre- and postsurvey results. The project can serve as a model for other university programs in the development of preservice preparation programs focusing on culturally and linguistically diverse students with AAC needs.


Assuntos
Auxiliares de Comunicação para Pessoas com Deficiência , Transtornos da Comunicação , Diversidade Cultural , Currículo , Patologia da Fala e Linguagem , Humanos , Patologia da Fala e Linguagem/educação , Transtornos da Comunicação/reabilitação , Transtornos da Comunicação/terapia , Educação de Pós-Graduação , Competência Cultural/educação , Estados Unidos , Linguística
14.
Am J Speech Lang Pathol ; 33(3): 1226-1235, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38329991

RESUMO

PURPOSE: Therapeutic bottle feeding is a critical skill for speech-language pathologists (SLPs) managing the increasing and medically complex neonatal intensive care unit (NICU) and early intervention caseloads. Thus, we explored the role of a high-emotion preterm simulator, known as "Paul," to increase knowledge, skills, and confidence related to infant feeding management for speech-language pathology graduate students. METHOD: A randomized controlled study compared learning outcomes of 27 participants following either a 1-hr lecture or 1-hr training with a preterm simulator. Outcomes included knowledge demonstrated on written examination, accuracy in identifying stress cues during simulated feeding, and self-reported anxiety levels related to clinically assessing infant feeding. RESULTS: No baseline group differences were found on written examination or during a simulated bottle feeding. Both groups improved in written examination scores and identification of stress cues (p < .001). Gains in written examination scores did not significantly differ between groups; however, after training, the simulator group correctly identified more stress cues during a simulated bottle feeding (p < .001), and the lecture group reported reduced anxiety related to clinically evaluating infant feeding compared to simulator-trained students (p < .05). CONCLUSIONS: All students demonstrated gains in written knowledge and identification of stress cues; however, simulation-based training was superior in developing the feeders' ability to identify stress cues during a hands-on simulated bottle-feeding scenario. Lecture-based training may have inflated students' perceptions in their clinical skills as they were less accurate in identifying stress cues during a simulated feeding but reported significantly reduced anxiety for administering a clinical evaluation of infant feeding compared to simulation-trained students. Hands-on training using high-fidelity simulation may capitalize on experiential learning to better build clinical feeding skills for future SLPs who may serve in NICU and early intervention settings, while eliminating the risk of potential errors during learning that could affect fragile neonates.


Assuntos
Alimentação com Mamadeira , Competência Clínica , Recém-Nascido Prematuro , Patologia da Fala e Linguagem , Humanos , Patologia da Fala e Linguagem/educação , Recém-Nascido , Feminino , Masculino , Emoções , Educação de Pós-Graduação/métodos , Adulto , Treinamento por Simulação/métodos , Adulto Jovem , Sinais (Psicologia) , Ansiedade/psicologia , Ansiedade/prevenção & controle
15.
Semin Speech Lang ; 45(2): 121-136, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38316421

RESUMO

The successful implementation of early interventions (EIs) within families is crucial in mitigating language and developmental delays in young children. Considering that language acquisition primarily occurs through interactions between caregivers and children, parental involvement plays a significant role in EI services. Working within families where one parent interferes with the involvement of the child's other parent or caregiver can be challenging for service providers. This article examines parental gatekeeping-a concept from the family science literature that can have a significant impact on services provided by speech language pathologists (SLPs). We outline and provide examples of family dynamics that may pose challenges to SLPs working with young children and their families as well as provide strategies for effectively navigating and working within these dynamics.


Assuntos
Transtornos da Comunicação , Patologia da Fala e Linguagem , Criança , Humanos , Pré-Escolar , Cuidadores , Pais , Intervenção Educacional Precoce , Desenvolvimento da Linguagem
16.
Am J Speech Lang Pathol ; 33(3): 1337-1355, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38346137

RESUMO

PURPOSE: Qualitative engagement with stakeholders in the development of interventions can provide insight into strategies to maximize feasibility in real-life settings. We engaged stakeholders (autistic adults, early childhood educators, early childhood sector leaders and policy influencers, parents of autistic children, and speech-language pathologists) to inform the development of an educator-led peer-mediated intervention (PMI) for autistic preschoolers who use minimal speech that is feasible to implement in inclusive early childhood education and care (ECEC) settings. METHOD: A qualitative iterative intervention design process was utilized. Stakeholders (N = 15) attended an online workshop and completed a document review exploring the acceptability and feasibility of the proposed embedded PMI. A two-step analysis procedure using the Theoretical Domains Framework and template analysis was conducted to identify the barriers, enablers, and supports to the implementation of embedded PMI in early childhood settings. RESULTS: While embedded PMI was unanimously acceptable to stakeholders, several participants expressed concerns regarding feasibility. Barriers to the successful integration and implementation of PMI in inclusive preschool contexts included access to skills, knowledge, and resources. Participants identified strategies to overcome modifiable barriers and to enhance the existing enablers. These strategies are reflected in the following themes: build on the familiar, build capacity in augmentative and alternative communication, adopt a whole center approach, adapt to meet the needs of the ECEC setting, and engage in proactive implementation. CONCLUSION: To address barriers to the implementation of embedded PMI, action is needed at various levels: macro (national/policy), meso (organization/setting), and micro (individual). SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25155770.


Assuntos
Estudos de Viabilidade , Grupo Associado , Pesquisa Qualitativa , Humanos , Pré-Escolar , Masculino , Feminino , Participação dos Interessados , Intervenção Educacional Precoce/métodos , Transtorno Autístico/terapia , Transtorno Autístico/psicologia , Transtorno do Espectro Autista/terapia , Transtorno do Espectro Autista/psicologia , Patologia da Fala e Linguagem/métodos , Adulto
17.
Am J Speech Lang Pathol ; 33(3): 1157-1173, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38363726

RESUMO

PURPOSE: Due to the scope of practice of speech-language pathology (SLP) expanding considerably in recent times, there is reduced emphasis on certain communication conditions within the curricula of SLP university programs. Stuttering and cluttering are neglected components of such curricula, despite the complex clinical skill set required to work with these client groups. Evaluation of the content and quality of modules on stuttering and cluttering is warranted to ensure that SLP students are graduating with adequate competence and confidence for supporting people with these conditions. This tutorial, based on a review of the literature, aims to provide guidance to educators who are designing or revising such modules. METHOD: The All Ireland Society for Higher Education (AISHE) model for module design provides a practical and theoretically underpinned guide to educators in higher education on the design of a new module or the review of an existing one. The model's seven key components are discussed, and their application to a module on stuttering and cluttering is outlined. RESULTS: The AISHE model provides a systematic and user-friendly approach to module design in SLP university programs. It supports educators who are designing a new module or revising a module currently being taught on stuttering and cluttering. CONCLUSIONS: Educators are encouraged to familiarize themselves with the seven components of the AISHE model and to use it as a tool to design or revise modules on stuttering and cluttering. This will ensure that SLP students are graduating with increased competence and confidence in working with these client groups.


Assuntos
Currículo , Patologia da Fala e Linguagem , Gagueira , Humanos , Patologia da Fala e Linguagem/educação , Gagueira/terapia , Gagueira/diagnóstico , Modelos Educacionais , Competência Clínica
18.
Am J Speech Lang Pathol ; 33(3): 1127-1141, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38381120

RESUMO

PURPOSE: More Than Words® (MTW) is a caregiver-mediated intervention program led by a speech-language pathologist (SLP) who teaches caregivers strategies to support their autistic child's early social communication and play development. The program includes group sessions composed of multiple families with children of varying profiles. We explored whether caregiver experiences and perceived outcomes of the virtual MTW program differed depending on the child's age and social communication stage. METHOD: As part of a program evaluation of virtual MTW delivered to over 2,000 families in Ontario, Canada, between 2020 and 2021, we randomly selected 31 families across four social communication stages and two age groups using stratified sampling (n = 4, in all but one subgroup). The Final Reflection and Evaluation form was analyzed both qualitatively and quantitatively, and a modified RE-AIM framework guided our analyses, including theme development. RESULTS: Child attributes did not appear to impact caregivers' experiences, but perceived child skill improvements varied by children's social communication stage. The majority of caregivers reported changes in how they interact with their child. Four themes emerged: (a) perceived child skill improvements differed by social communication stage, (b) caregivers gained new knowledge and strategies regardless of child attributes, (c) SLPs effectively managed families' individual needs, and (d) program components were appropriate for a variety of families. CONCLUSIONS: Findings suggest that the content taught in the MTW program was relevant for a variety of children, including those beyond the program's intended age of 5 years and under. Grouping families of children with varying profiles does not appear to negatively influence caregivers' experiences or perceived outcomes. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25237009.


Assuntos
Cuidadores , Patologia da Fala e Linguagem , Humanos , Cuidadores/psicologia , Pré-Escolar , Masculino , Feminino , Ontário , Patologia da Fala e Linguagem/métodos , Criança , Avaliação de Programas e Projetos de Saúde , Transtorno Autístico/psicologia , Transtorno Autístico/terapia , Lactente , Transtorno do Espectro Autista/terapia , Transtorno do Espectro Autista/psicologia , Adulto , Comunicação , Jogos e Brinquedos
19.
Am J Speech Lang Pathol ; 33(3): 1356-1372, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38387874

RESUMO

PURPOSE: This quality improvement project aimed to address the inconsistent use of clinical labels across a preschool speech and language program in Ontario, Canada. The study investigated whether a multicomponent knowledge translation (KT) intervention could increase speech-language pathologists' (SLPs') knowledge about the recommended clinical labels, motivate their intentions to use the labels, and facilitate practice change during a 3-month pilot period. METHOD: The diffusion of innovations theory was utilized to identify and address known and suspected barriers and facilitators that could influence the adoption of consistent terminology. The intervention was evaluated using a pre-experimental study design (with pre, post, and follow-up testing) and included two phases: Phase 1 involved the pretraining survey, KT intervention, and posttraining survey, and Phase 2 included an exit survey after a 3-month pilot period. RESULTS: Five hundred twenty-nine SLPs in Phase 1 and 387 SLPs in Phase 2 participated. Following the web-based intervention, SLPs demonstrated improved knowledge about the recommended labels with most indicating intentions to communicate the labels going forward. SLPs also reported increased comfort using labels and positive views on their importance and value. After the 3-month pilot period, SLPs' reported use of most recommended labels decreased, as did ratings of comfort, value, and importance. However, most SLPs reported intentions to use the labels going forward. CONCLUSIONS: Despite having intentions to adopt the recommended labels, the lack of implementation by SLPs suggests the presence of additional barriers impacting their use of the recommended clinical labels in practice. Future work should investigate clinician-identified barriers to inform future implementation efforts. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25254940.


Assuntos
Patologia da Fala e Linguagem , Terminologia como Assunto , Humanos , Patologia da Fala e Linguagem/métodos , Pré-Escolar , Ontário , Feminino , Masculino , Projetos Piloto , Conhecimentos, Atitudes e Prática em Saúde , Atitude do Pessoal de Saúde , Difusão de Inovações , Melhoria de Qualidade , Linguagem Infantil
20.
Lang Speech Hear Serv Sch ; 55(2): 394-408, 2024 04 11.
Artigo em Inglês | MEDLINE | ID: mdl-38227486

RESUMO

PURPOSE: The purpose of this clinical focus article is to discuss processes and procedures for building school-based programs to address the feeding and swallowing needs of students in the public-school setting. Interprofessional practice (IPP) team member roles and responsibilities, screening, eligibility, considerations for developing Individualized Education Programs that address the needs of students with pediatric feeding disorder (PFD) and dysphagia, as well as billing documentation requirements, are discussed. Additionally, coordination across the continuum of service delivery for students with PFD and dysphagia is investigated. Guidance on documentation, processes, and procedures that comply with the Individuals with Disabilities Education Act mandates will be provided. CONCLUSIONS: This clinical focus article will demonstrate that students with PFD and dysphagia continue to present to public schools and require skilled services and supports in order to meet their individualized needs. School-based speech-language pathologists have a legal requirement to provide these supports when deemed educationally relevant. Schools must employ processes and procedures that result in the timely and effective evaluation and identification of students with PFD and dysphagia. An IPP approach to the management of PFD and dysphagia is critical to ensure optimal outcomes for students found eligible for services.


Assuntos
Transtornos de Deglutição , Deficiências da Aprendizagem , Patologia da Fala e Linguagem , Criança , Humanos , Transtornos de Deglutição/terapia , Instituições Acadêmicas , Comportamento Social , Serviços de Saúde Escolar , Patologia da Fala e Linguagem/métodos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA