Education for practice in the UK and Ireland: implementing problem-based learning.

OBJECTIVE: This paper outlines the education of speech and language therapists in the UK and Ireland, and presents a preliminary study of student therapists' perceptions of problem-based learning (PBL) as a learning strategy in preparation for clinical work. PBL has been used extensively in medical and dental education in Europe, in Canada, and in the Middle East, and has been applied to speech and language therapist education in Sweden and in Australia. Its implementation in the UK and Ireland is relatively new. METHODS: A survey questionnaire was circulated to students in two centres via e-mail. Questions posed included student impressions of the most and least useful elements of PBL in their preparation for clinical practice, as well as how they considered improvements could be made; student reflections regarding PBL were also sought. RESULTS AND CONCLUSIONS: Findings support the implementation of PBL in the education of speech and language therapists, with more experienced students showing more positive support for PBL. Issues raised by the study include emphasis on clinical relevance of problems, particularly in the early years of the course. The majority of students regarded PBL as directly relevant for clinical preparation.

The phonological abilities of Cantonese-speaking children with hearing loss.

Little is known about the acquisition of phonology by children with hearing loss who learn languages other than English. In this study, the phonological abilities of 12 Cantonese-speaking children (ages 4:2 to 6:11) with prelingual hearing impairment are described. All but 3 children had almost complete syllable-initial consonant repertoires; all but 2 had complete syllable-final consonant and vowel repertoires; and only 1 child failed to produce all nine tones. Children's perception of single words was assessed using sets of words that included tone, consonant, and semantic distractors. Although the performance of the subjects was not age appropriate, they nevertheless most often chose the target, with most errors observed for the tone distractor. The phonological rules used included those that characterize the speech of younger hearing children acquiring Cantonese (e.g., cluster reduction, stopping, and deaspiration). However, most children also used at least one unusual phonological rule (e.g., frication, addition, initial consonant deletion, and/or backing). These rules are common in the speech of Cantonese-speaking children diagnosed as phonologically disordered. The influence of the ambient language on children's patterns of phonological errors is discussed.

Down's syndrome and the acquisition of phonology by Cantonese-speaking children.

The phonological abilities of two groups of 4-9-year-old intellectually impaired Cantonese-speaking children are described. Children with Down's syndrome did not differ from matched non-Down's syndrome controls in terms of a lexical comprehension measure, the size of their phoneme repertoires, the range of sounds affected by articulatory imprecision, or the number of consonants, vowels or tones produced in error. However, the types of errors made by the Down's syndrome children were different from those made by the control subjects. Cantonese-speaking children with Down's syndrome, as compared with controls, made a greater number of inconsistent errors, were more likely to produce non-developmental errors and were better in imitation than in spontaneous production. Despite extensive differences between the phonological structures of Cantonese and English, children with Down's syndrome acquiring these languages show the same characteristic pattern of speech errors. One unexpected finding was that the control group of non-Down's syndrome children failed to present with delayed phonological development typically reported for their English-speaking counterparts. The argument made is that cross-linguistic studies of intellectually impaired children's language acquisition provide evidence concerning language-specific characteristics of impairment, as opposed to those characteristics that, remaining constant across languages, are an integral part of the disorder. The results reported here support the hypothesis that the speech disorder typically associated with Down's syndrome arises from impaired phonological planning, i.e. a cognitive linguistic deficit.

The acquisition of phonology by Cantonese-speaking children.

Little is known about the acquisition of phonology by children learning Cantonese as their first language. This paper describes the phoneme repertoires and phonological error patterns used by 268 Cantonese-speaking children aged 2;0 to 6;0, as well as a longitudinal study of tone acquisition by four children aged 1;2 to 2;0. Children had mastered the contrastive use of tones and vowels by two years. While the order of acquisition of consonants was similar to that reported for English, the rate of acquisition was more rapid. The developmental error patterns used by more than 10% of children are also reported as common in other languages. However, specific rules associated with Cantonese phonology were also identified. Few phonological errors were made after age four. The results are consistent with the hypothesis that the ambient language influences the implementation of universal tendencies in phonological acquisition.

The evaluation of intervention programmes for communicatively impaired elderly people.

A study is described which examined the efficacy of group intervention programmes using trained volunteers as agents of intervention with elderly nursing home residents with communication impairments. A series of intervention programmes, which consisted of six weekly sessions, was designed. Sessions were a combination of information giving, discussion and practical components where residents could practise newly acquired skills. Sessions covered a number of core components--the communication process, comprehension, expression and pragmatics, as well as information that was specific to the communication impairment. Volunteers were trained to administer the programme. Four groups of communicatively impaired elderly people were included in the study--a group of hearing-impaired residents, those with communication impairment subsequent to Parkinson's disease, those with communication impairment subsequent to cerebrovascular accident and those in varying stages of dementia. Results indicated that, although the residents studied responded very individually to the intervention strategies, with several subjects failing to demonstrate any gains in communicative competence from pre- to post-intervention, positive gains in communication skills and self-management of communicative impairment were observed for a number of subjects. Complicating factors such as general health and well-being are considered as uncontrollable variables in the measurement of performance in the elderly.