What Is Working for Practitioners: A Mixed Method Analysis Using the Collaborative Practice Assessment Tool.

Interprofessional practice (IPP) is thought to increase coordination of care and provide numerous benefits for clients and practitioners. While the importance of interprofessional education and practice has been emphasized in the literature and by numerous organizations including the World Health Organization, understanding what is working for practitioners is still elusive. Using the World Health Organization's framework regarding IPP and the Interprofessional Education Collaborative (IPEC) guidelines and competencies, this research attempted to identify what is working for practitioners when it comes to IPP and where opportunities for growth are still evident. The Collaborative Practice Assessment Tool was distributed to practitioners across disciplines, with a focus on speech-language pathologists and behavior analysts, and both qualitative and quantitative measures were analyzed to determine what reported IPP strategies are in use. Results indicated that practitioners are more similar than they are different when it comes to what is working with regard to the IPEC competencies (i.e., values/ethics for interprofessional practice, roles/responsibilities, interprofessional communication, and teams and teamwork) and where change is needed. Discussion and suggestions relevant to clinical practice were identified and a call for development of IPP training across and within disciplines based on IPEC competencies is recommended.

Written cohesion in children with and without language learning disabilities.

BACKGROUND: Cohesion refers to the linguistic elements of discourse that contribute to its continuity and is an important element to consider as part of written language intervention, especially in children with language learning disabilities (LLD). There is substantial evidence that children with LLD perform more poorly than typically developing (TD) peers on measures of cohesion in spoken language and on written transcription measures; however, there is far less research comparing groups on cohesion as a measure of written language across genres. AIMS: The current study addresses this gap through the following two aims. First, to describe and compare cohesion in narrative and expository writing samples of children with and without language learning disabilities. Second, to relate measures of cohesion to written transcription and translation measures, oral language, and writing quality. METHODS & PROCEDURES: Fifty intermediate-grade children produced one narrative and one expository writing sample from which measures of written cohesion were obtained. These included the frequency, adequacy and complexity of referential and conjunctive ties. OUTCOMES & RESULTS: Expository samples resulted in more complex cohesive ties and children with TD used more complex ties than peers with LLD. Different relationships among cohesion measures and writing were observed for narrative verse expository samples. CONCLUSIONS & IMPLICATIONS: Findings from this study demonstrate cohesion as a discourse-level measure of written transcription and how the use of cohesion can vary by genre and group (LLD, TD). Clinical implications for assessment, intervention, and future research are provided.

Writing in Elementary Students With Language-Based Learning Disabilities: A Pilot Study to Examine Feasibility and Promise.

PURPOSE: Although children with language-based learning disabilities (LLD) demonstrate significant difficulties with writing, empirical evidence to support interventions is sparse. Therefore, the purpose of this pilot study was to examine the feasibility and promise of a writing intervention for fourth- and fifth-grade students with LLD (WILLD: writing in students with LLD). The intervention components included word-, sentence-, and discourse-level writing processes and instructional practices using self-regulation strategies. METHOD: Participants for this study were 15 students with LLD, recruited from three different schools. Students' writing was assessed using a sentence probe task and obtaining an informative paragraph writing sample as a measure of proximal writing outcomes. Trained speech-language pathologists (SLPs) and special educators delivered the intervention in a small-group format over 12 weeks. Using a within-group pre-post design, we examined changes in writing outcomes before and after the intervention. RESULTS: Results indicated that the intervention helped students improve their informative writing skills; students' writing quality showed a statistically significant increase, and grammatical errors showed a significant decrease. CONCLUSIONS: Evidence from this pilot effort indicates that WILLD was feasible and appears to show promise for improving writing outcomes for fourth- and fifth-grade students with LLD when delivered by SLPs and special educators in a small-group format. Implications of the results and directions for future research are discussed. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.26053132.

Three-Year Program Evaluation of a University-Public School Collaborative Partnership.

PURPOSE: This clinical focus article reports on an innovative program that provides classroom-based speech and language services to school children receiving speech-language therapy while addressing the need for clinical placements for graduate students in speech-language pathology. This program evaluation report centers around the logic model used to develop and implement the program. METHOD: The program was implemented in partnership between a university program in speech-language pathology and a nearby school district. The program took place in two different schools within the district, each with one state licensed and American Speech-Language-Hearing Association-certified speech-language pathologist (SLP) who supervised two or three graduate student interns per year of the project for a total of 17 graduate students over 3 years. Data sources for this program evaluation included child-level data collected by graduate student interns, teacher satisfaction surveys, and semistructured interviews. RESULTS: Program stakeholders including graduate student interns, speech-language pathology supervisors, and the school district administrator provided converging positive feedback about the program implementation. This was corroborated by favorable ratings from teachers who collaborated with graduate student interns and an increase in the number of classroom-based intervention hours for school children receiving speech-language services. CONCLUSIONS: The short-, medium-, and long-term outcomes of the program's logic model were achieved in part or fully as supported by data sources used for program evaluation procedures. Clinical implications are provided about the need for innovation in school-based services with a focus on collaborative classroom-based intervention.

Evaluating measures of global coherence ability in stories in adults.

BACKGROUND: Discourse coherence is a reflection of the listener's ability to interpret the overall meaning conveyed by the speaker. Measuring global coherence (maintenance of thematic unity of the discourse) is useful for quantifying communication impairments at the discourse level in clinical populations and for measuring response to discourse-level treatments. AIMS: The aim was to determine feasibility of a four-point global coherence scale developed by the authors. Specifically, they were (1) to estimate measurement reliability of the four-point global coherence scale; and (2) to estimate construct validity for the four-point global coherence scale. METHOD & PROCEDURES: Fifty cognitively healthy adults aged between 28 and 58 years participated in the study. Participants viewed and then told the stories depicted in two wordless picture books. Participants' stories were orthographically transcribed and segmented into communication units (C-unit). Raters scored each participant's story for global coherence using two global coherence scales (four- and five-point scales). Each C-unit received an individual score, then the mean global coherence score was computed, resulting in two mean global coherence scores for each coherence scale, one for each story, for all participants. OUTCOMES & RESULTS: Results indicated high reliability estimates for the scale. In addition, construct validity, specifically face validity and convergent validity, was effectively estimated for using the four-point scale as a measure of maintenance of global coherence in stories told by cognitively healthy adults. Lastly, it was found that the wordless picture books elicited stories that are comparable and can be reliably interchanged as different forms to evaluate maintenance of global coherence. CONCLUSIONS & IMPLICATIONS: The assumptions that the measure is feasible were achieved and face and convergent validity were adequately estimated. Future investigations should consider estimating predictive validity, concurrent validity and discriminant validity of the measure.

How Do Intermediate Grade Students With and Without Language-Based Learning Disabilities Use Noun Phrases in Narrative Writing?

PURPOSE: Noun phrase usage and elaboration is an important feature of literate language. In this study, we described noun phrase usage and elaboration in the narrative writing samples of intermediate grade students with and without language-based learning disabilities. METHOD: Narrative writing samples from 64 students in fourth through sixth grades were coded for five types of noun phrases using coding procedures adapted from prior research. Noun phrase ratios (NPR) were calculated for each type of noun phrase evaluated in the study. NPRs represented the proportion of noun phrases to total clauses produced in the sample. RESULTS: Students in this study included all five types of noun phrases in their narrative writing to varying degrees. Between-group differences were observed in the frequency of complex noun phrase usage. Significant relationships between NPRs, analytic writing measures, and a standardized reading measure were observed. CONCLUSIONS: Noun phrase usage is an important consideration for both theoretical and clinical purposes. Findings from this study are related to theoretical models of writing and levels of language frameworks. The clinical relevance for noun phrase assessment and intervention for intermediate grade students with language-based learning disability is discussed.

The effect of Tier 2 intervention for phonemic awareness in a response-to-intervention model in low-income preschool classrooms.

PURPOSE: This study assessed the effectiveness of a Tier 2 intervention that was designed to increase the phonemic awareness skills of low-income preschoolers who were enrolled in Early Reading First classrooms. METHOD: Thirty-four preschoolers participated in a multiple baseline across participants treatment design. Tier 2 intervention for beginning sound awareness was provided twice weekly in small groups over 6 weeks by trained teachers and speech-language pathologists (SLPs). RESULTS: The intervention was successful for 71% of the children, as indicated by medium to large effect sizes. Comparisons between children who did and did not qualify for intervention suggest that Tier 2 intervention helped narrow the gap in beginning sound awareness that had begun to emerge before treatment. Although children receiving special education and those learning English as a second language were enrolled in the classrooms, they were not overrepresented in the group qualifying for Tier 2 intervention, and most who did qualify demonstrated a positive response to intervention. CONCLUSION: In a relatively short period of time, preschoolers' phonemic awareness skills were increased through small-group Tier 2 intervention provided by teachers and SLPs. Findings indicate the potential of Tier 2 interventions to positively impact the future reading skills of children who are at risk for later reading difficulties.

Writing Process Products in Intermediate-Grade Children With and Without Language-Based Learning Disabilities.

Purpose: Difficulties with written expression are an important consideration in the assessment and treatment of school-age children. This study evaluated how intermediate-grade children with and without written language difficulties fared on a writing task housed within the Hayes and Berninger (2014) writing process framework. Method: Sixty-four children completed a writing task whereby they planned, wrote, and revised a narrative story across 3 days. Children had extended time to produce an outline, first draft, and final copy of their story. Language transcription approaches were used to obtain measures reflecting writing productivity, complexity, accuracy, and mechanics, in addition to measures of planning and revision. Results: Results indicated that children with writing difficulties produced poorer quality stories compared with their peers yet were not significantly different across all measures. Children with typical development produced longer stories with better spelling accuracy. Writing process measures predicted significant amounts of variance in writing quality across the sample. Discussion: Writing should be considered as part of language assessment and intervention, whether as the sole language difficulty or alongside difficulties with speaking, listening, or reading in children with language-based learning difficulties. Implications for translation of research to practice and service delivery are provided.

Global coherence in younger and older adults: Influence of cognitive processes and discourse type.

The purpose of the present research was to examine the influence of cognitive processes on discourse global coherence ability measured across different discourse tasks and collected from younger (n = 40; 20-39 years) and older (n = 40; 70-87 years) cognitively healthy adults. Study participants produced oral language samples in response to five commonly used discourse elicitation tasks and they were analyzed for maintenance of global coherence. Participants also completed memory and attention measures. Group differences on the global coherence scale were found for only one type of discourse-recounts. Across discourse elicitation tasks the lowest global coherence scores were found for recounts compared to the other discourse elicitation tasks. The influence of cognitive processes on maintenance of global coherence differed for the two age groups. For the younger group, there were no observed significant relationships. For the older group, cognitive measures were related to global coherence of stories and procedures.

Comparison of narrative and expository writing in students with and without language-learning disabilities.

PURPOSE: Students with language-learning disabilities (LLD) demonstrate difficulties with written language, especially in the areas of productivity, complexity, and grammar. It is not clear how these deficits affect their performance on high-stakes tests, such as those required by the No Child Left Behind Act (U.S. Department of Education, 2002). This study used writing samples to compare how students with and without LLD scored on analytic writing measures that are typically used in writing research and on a more holistic measure of writing, the six-traits writing rubric (STWR; Education Northwest, 2006), which is used in high-stakes writing assessments. METHOD: Fifty-six 4th and 5th graders with typical development (TD) or LLD produced 1 narrative and 1 expository writing sample. Measures of oral language ability and handwriting accuracy-speed were also obtained. The narrative and expository samples were scored using 5-6 separate analytic measures and 6 separate traits on the STWR. RESULTS: On narratives, the TD group scored significantly higher than the LLD group on 5 analytic measures and all 6 traits. Similarly, for expository, the TD group outscored the LLD group on 3 analytic measures and all 6 traits. Results demonstrate that the analytic scores of productivity, sentence complexity, and lexical diversity were correlated significantly with a higher overall score on the STWR for narrative writing samples only. DISCUSSION: Results of this study suggest that exclusive use of analytic scores to select treatment goals and document writing progress may not translate into increased scores on writing rubrics, particularly for expository writing samples.