One size does not fit all: improving clinical practice in older children and adolescents with language and learning disorders.

PURPOSE: In the lead article for this clinical forum, Kamhi (2014) suggests ways that current knowledge on instructional practices in learning and language can be applied to clinical practice in language disorders. I propose that Kamhi's suggestions are in need of fine-tuning for older children and adolescents with language disorders. A one-size-fits-all approach to language intervention across a broad age range is untenable due to unique needs and capabilities of this older population. METHOD: Three intervention goal priorities for older students are presented with supporting research: complex (multiclausal) sentences, verb structure, and expository text. Methodologies for teaching complex sentences are discussed next, including topics of content/form balance and treatment intensity. These goals and methods are designed to assist students with language disorders in the comprehension and production of complex language they encounter in school. CONCLUSION: Guidance for high-priority language intervention goals with older students comes from a consideration of language needs in academic settings and language weaknesses that persist in this population. Although current research offers support for these goals, less is known about methodological variables such as treatment intensity.

The impact of the consumer on healthcare delivery.

The authors of the lead articles are correct that the customer experience should be at the forefront of our attention and work in healthcare delivery. Expanding our current definitions of customer satisfaction and patient safety to include the important intangibles of "experience" will be key. However, a singular focus on patient or consumer experience is not enough in the long run. A solid business model and an understanding of the healthcare market dynamics are also required. The promises we make in support of our business strategy are at the core of how we interact with our patients, how we ensure their safety, and how we build their loyalty. Our work as healthcare leaders should be to keep those promises.