Speech-Language Pathologist Self-Efficacy and Job Satisfaction: Resources in Special Education Eligibility Decisions.

PURPOSE: Situated within the conservation of resources theory, this study sought to understand how resources such as self-efficacy, job satisfaction, caseload size, and geographic location influence the number of data sources used by school-based speech-language pathologists (SLPs) to determine eligibility. METHOD: Using a cross-sectional descriptive design, 665 school-based SLPs from the United States reported professional demographics, workload, and assessment/eligibility characteristics, as well as levels of job satisfaction and self-efficacy. Multiple regression was used to examine the effects of self-efficacy, job satisfaction, caseload size, and geographic location on the number of data sources used in eligibility decision making and to examine the effects of caseload size and job satisfaction resources on SLP self-efficacy. RESULTS: SLPs, on average, reported using 7.98 data sources to support eligibility determinations. Standardized tests, conversation samples, and review of records were most used, and literacy assessments were used least. Results of multiple regression models indicate that SLPs with higher self-efficacy scores reported using significantly more data sources and that SLPs with higher job satisfaction indicated significantly higher self-efficacy. CONCLUSIONS: This study affirms self-efficacy as a strong resource for school-based SLPs and that it is, in fact, related to the number of data sources used in eligibility decisions. Limited literacy assessment was reported, despite the SLP's critical role in an educational setting. Job satisfaction as a predictor of self-efficacy and self-efficacy, in turn, as a predictor of data sources underscore the need for SLPs to advocate for work conditions that support their work.

Revisiting the definition of dyslexia.

The International Dyslexia Association definition of dyslexia was updated 20 years ago and has been referenced frequently in research and practice. In this paper, researchers from the Florida Center for Reading Research consider the components of the definition and make recommendations for revisions. These include recognizing the persistence of word-reading, decoding, and spelling difficulties, acknowledging the multifactorial causal basis of dyslexia, clarifying exclusionary factors, and denoting comorbidity with other developmental disorders. It is also suggested that the academic and psychosocial consequences of dyslexia be highlighted to reinforce a preventive service delivery model. Lastly, the inclusion of dyslexia within a specific learning disability category is supported.

Examining Graduate Training in Written Language and the Impact on Speech-Language Pathologists' Practice: Perspectives From Faculty and Clinicians.

PURPOSE: This study had two aims. Aim 1 was to query both communication science and disorders (CSD) faculty and school-based speech-language pathologists (SLPs) regarding how written language is/was covered in their graduate programs. Aim 2 was to query school-based SLPs about their written language service provision. METHOD: CSD faculty (n = 143) and school-based SLPs (n = 610) completed an online survey examining (a) if and how written language was addressed in their graduate program, (b) what content related to written language was covered in graduate school, and (c) provision of written language services in schools (SLPs only). RESULTS: There was a discrepancy in reports of training provision. Faculty reported providing more training than SLPs reported receiving. However, SLPs with fewer years of experience reported slightly higher levels of training compared to those with more years of experience. Additionally, there was variability among SLPs in how often they targeted written language in therapy. Finally, receipt of training in written language was a significant predictor of provision of written language services, as reported by SLPs. CONCLUSIONS: SLPs play a key role on literacy teams in schools, but many SLPs did not receive adequate training in written language. In order to ensure SLPs are trained to work with children with reading difficulties, graduate programs should ensure that written language is part of the clinical and academic curricula. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.24543469.

Subtract Before You Add: Toward the Development of a De-Implementation Approach in School-Based Speech Sound Therapy.

PURPOSE: It is often difficult for school-based speech-language pathologists (SLPs) to prioritize implementing new practices for children with speech sound disorders (SSDs), given burgeoning caseloads and the myriad of other workload tasks. We propose that de-implementation science is equally as important as implementation science. De-implementation science is the recognition and identification of areas that are of "low-value and wasteful." Critically, the idea of de-implementation suggests that we first remove something from a clinician's workload before requesting that they learn and implement something new. METHOD: Situated within the Sustainability in Healthcare by Allocating Resources Effectively (SHARE) framework, we review de-implementation science and current speech sound therapy literature to understand the mechanisms behind continuous use of practices that are no longer supported by science or legislation. We use vignettes to highlight real-life examples that clinicians may be facing in school-based settings and to provide hypothetical solutions, resources, and/or next steps to these common challenges. RESULTS: By focusing on Phase 1 of the SHARE framework, we identified four primary practices that can be de-implemented to make space for new evidence-based techniques and approaches. These four practices were determined based on an in-depth review of SLP-based survey research: (a) overreliance on speech sound norms for eligibility determinations, (b) the omission of phonological processing skills within evaluations, (c) homogeneity of service delivery factors, and (d) the use of only one treatment approach for all children with SSDs. CONCLUSIONS: De-implementation will take work and may lead to some difficult discussions. Implementing a framework, such as SHARE, can guide SLPs toward a reduction in workloads and improved outcomes for children with SSDs.

School-Based Speech-Language Pathologists' Stress and Burnout: A Cross-Sectional Survey at the Height of the COVID-19 Pandemic.

PURPOSE: Low retention of school-based speech-language pathologists (SLPs) is a growing problem that can have drastic consequences at the school and student levels. Factors contributing to this shortage include features of the work environment, role ambiguity, low salaries, and a demanding workload with higher caseloads, which can result in limited time for paperwork and lesson planning for optimal service delivery models. The purpose of this study was to determine the current levels and predictors of occupational stress and burnout SLPs are experiencing in the school setting. METHOD: Using a cross-sectional survey design, 453 school-based SLPs from across the United States reported their workload manageability, career intentions, access to social support, and their stress and burnout levels. Multiple linear regression was used to determine the relation between the variables of interest and the occupational stress and burnout scores. Data were collected in September to December of 2020, at the height of the COVID-19 pandemic. RESULTS: SLPs, on average, reported overall stress levels in the somewhat noticeable range, moderate access to social support, high levels of emotional exhaustion, low-to-moderate feelings of depersonalization, and moderate-to-high feelings of personal accomplishments. Based on a standardized burnout scale, SLPs in this sample are characterized as feeling ineffective and overextended. Results of linear regression models suggest that the perception of work manageability was the best predictor of Total Stress score, Emotional Exhaustion score, and Depersonalization score, in this sample. CONCLUSIONS: Data from this study offer the beginning steps to making an informed change for school-based SLPs' workplaces. Results indicated that SLPs in the school setting are feeling ineffective and overextended. The perception of their workload manageability was the most significant predictor for their reported stress and burnout levels. Suggestions for SLP supervisors, administrators, and other stakeholders are discussed.

Phonological processing skills in children with speech sound disorder: A multiple case study approach.

BACKGROUND: Children with speech sound disorder (SSD) are at increased risk of reading difficulties due to poor phonological processing skills. However, the extent to which children with SSD demonstrate weaknesses on specific or all phonological processing tasks is not well understood. AIMS: To examine the phonological processing abilities of a clinically identified sample of children with SSD, with and without reading difficulties. To determine the extent to which the proportion of children with concomitant SSD and reading difficulties exhibited weaknesses in specific areas of phonological processing, or a more general phonological deficit. METHODS & PROCEDURES: Data were obtained from 157 school-aged children (Mage = 77 months, SD = 7.01) in receipt of school-based speech therapy. Approximately 25% of the sample was identified as poor readers, based on a standardized measure of word decoding. We compared the proportion of children who scored at or below 1 SD below the mean, or the bottom 16th percentile, on measures of phonological awareness, rapid automatized naming and verbal short-term memory among those identified as poor readers and good readers. OUTCOMES & RESULTS: Children with SSD demonstrated a range of phonological processing difficulties, particularly on the measure of verbal short-term memory. No specific skill differentiated groups of children with SSD with and without reading difficulties; however, those classified as poor readers on the word-decoding measure exhibited more widespread difficulties, even after controlling for language ability. CONCLUSIONS & IMPLICATIONS: Results support a cumulative risk model such that children with SSD and reading difficulties are likely to demonstrate generally poor phonological processing abilities. WHAT THIS PAPER ADDS: What is already known on the subject Children with SSD are at heightened risk of reading difficulties, particularly if their SSD persists into school age. However, not all children with SSD experience reading problems. Research aimed at determining which children are at the highest risk is mixed as to how best to identify which children with SSD are most likely to experience reading difficulties. What this paper adds to existing knowledge The study used a multiple case study approach to determine if performance on phonological processing skills might differentiate children with SSD who were poor readers from those who were good readers. As a group, children with SSD exhibited poor verbal short-term memory but relatively intact rapid automatized naming skills. No one phonological processing skill differentiated children who were poor readers from good readers. However, children with reading difficulties appeared to experience more general difficulties across phonological processing tasks, even after controlling for language abilities. What are the potential or actual clinical implications of this work? A single deficit (i.e., speech sound production) is not sufficient data to make a complete diagnosis or treatment decisions. Multiple sources of data, including several aspects of phonological processing, should be obtained to understand reading risk in children with SSD.

Practice-Based Coaching for Speech-Language Pathologists Supporting Paraeducators and Speech-Language Pathology Assistants.

PURPOSE: This tutorial is designed for speech-language pathologists who supervise speech-language pathology assistants (SLP-As) and/ or paraeducators. SLP-As and paraeducators often support young children with disabilities within early childhood settings, but do not always have access to professional development to learn and/or enhance their skill set. Practice-based coaching (PBC) provides a collaborative framework under which professionals can effectively implement instructional strategies with fidelity to support preschool children with language delays. CONCLUSIONS: In this tutorial, we will share the components of PBC including implementation materials that can be immediately utilized by SLPs. We will also share methods for embedding effective vocabulary instruction into shared book reading sessions to ensure early literacy instruction is more accessible to learners with varying educational needs.

Auditory Experience, Speech Sound Production Growth, and Early Literacy in Children Who Are Hard of Hearing.

PURPOSE: Children who are hard of hearing (CHH) are at risk for literacy difficulties. Speech sound production is related to literacy skills in typically hearing children. Speech sound production abilities can also be markedly weak in CHH due to inconsistent access to the speech signal. We longitudinally examined relations between auditory experience, speech sound production abilities, and literacy (i.e., nonword reading and spelling in second grade) in CHH. METHOD: Participants included 166 CHH. All participants used hearing aids (HAs). Auditory experience is a weighted measure of the number of hours of daily HA use and the amount of audibility with and without their HAs. Children's speech sound production was tested 2-3 times between the ages of 3 and 9 years. At age 5 years and again in second grade, children were tested on a battery of language and literacy measures. RESULTS: Auditory experience was significantly correlated with speech sound production abilities, but age at HA fitting was not. Speech sound production abilities at age 5 years did not predict nonword reading in second grade but did predict spelling skills in second grade. CONCLUSIONS: Our results support the importance of auditory experience and speech sound production for later literacy abilities. Specifically, we found that speech sound production abilities and print knowledge at age 5 years are related to second grade spelling outcomes. Interestingly, we found that morphological knowledge at age 5 years was more predictive of decoding in second grade than was speech sound production. Although there are multiple factors that contribute to literacy success, our results underscore the unique contributions of speech sound production abilities in CHH.

Introduction: Innovations in Treatment for Children With Speech Sound Disorders.

PURPOSE: There is a clear need for effective and efficient interventions for children with speech sound disorder (SSD) that can be implemented in both clinical and school-based settings. METHOD: This forum was created for any clinician who treats SSDs. We asked the invited authors to include immediately actionable information, such as therapy activities, tips for goal writing or progress monitoring, assessment processes, and frameworks for conversations with parents. RESULTS: We have curated nine scientifically based articles that highlight the heterogeneity of SSDs and how various subpopulations require uniquely tailored interventions. Some children with SSDs require treatment approaches that are more heavily embedded in phonological theories (e.g., maximal or multiple oppositions) or that extend beyond speech production and include speech perception and phonological awareness skills. Clinicians also need to be mindful of not only which sounds are affected, but which kinds of errors a child is making. For instance, lateral lisps and residual speech sound errors should be evaluated and treated differently from other kinds of speech sound errors. There are certainly subpopulations of children with SSDs for whom there is extremely limited data upon which speech-language pathologists can base clinical decisions, such as children under the age of 3 years or children who are multilingual. Finally, there is a crucial need to better understand the social-emotional impacts of SSDs. Tools to aid in including social-emotional data within assessment and intervention outcomes are also included in this forum. CONCLUSION: The traditional articulation approach is the most commonly used approach in school-based settings; however, there are many children for whom this approach is not appropriate. We hope to provide a robust resource for busy school-based speech-language pathologists who treat children with SSD-specifically, we hope clinicians embrace the opportunity to "think outside the box" of traditional articulation therapy.

Speech Sound Disorder Treatment Approaches Used by School-Based Clinicians: An Application of the Experience Sampling Method.

PURPOSE: Children with speech sound disorders (SSDs) comprise a large portion of caseloads for school-based speech-language pathologists (SLPs). Despite the existence of several evidence-based SSD intervention approaches, the translation from research to practice is often limited by ecological validity because of various factors unique to school settings (e.g., scheduling constraints, caseload size, child availability). The purpose of this study was to use the experience sampling method (ESM) to examine the current practices of school-based SLPs when treating children with SSDs on their caseloads. METHOD: SLPs (N = 106) from 42 different states working full-time in school-based K-12 settings participated in this study. At the beginning of the study, each SLP completed a one-time demographic survey about treatment practices for children with SSDs. The SLPs then participated in a series of brief surveys every day for one workweek using a specialized ESM phone application that randomly alerted participants to report on their treatment practices for children with SSDs. RESULTS: Findings revealed that although most SLPs reported using a variety of SSD intervention approaches in a one-time survey, the majority of SLPs reported using one of three approaches in situ: the traditional articulation therapy approach, cycles, and minimal pairs. We also report a significant negative relationship between the years of experience of an SLP and the number of different approaches used. CONCLUSIONS: This study is the first to use the ESM to determine which approaches school-based SLPs use to treat children with SSDs. Findings demonstrate that SLPs have knowledge of many different SSD approaches but tend to utilize only a few in school-based settings.

Speech-language pathologists' perspectives of interprofessional collaboration.

This study aims to provide insight into speech-language pathologists' experiences of and preparation for interprofessional collaborative practice across various settings and geographical locations in the United States. We disseminated an online survey via Qualtrics© to reach a representative sample of speech-language pathologists. We questioned respondents about the extend to which they engage in interprofessional collaborative practice, professionals with whom they engage in interprofessional collaborative practice, preparation for interprofessional collaborative practice, and barriers to engaging in interprofessional collaborative practice. Responses from 296 participants were analyzed to describe details regarding speech-language pathologists' experiences in interprofessional collaboration. Quantitative data included means, ranges, standard deviations, and frequency counts. Open-ended responses underwent analysis through a consensual qualitative approach. Most speech-language pathologists in this study (59%) reported feeling prepared for interprofessional collaboration. Participants reported that they engage in interprofessional collaborative practice with other professionals from disciplines such as nursing, occupational therapy, teaching, physical therapy, and school psychology. To best prepare students for future speech-language pathology practice, participants recommended that students engage in interprofessional education to learn about collaborating with these disciplines. These results could have implications for future design and implementation of interprofessional education activities for students and practicing clinicians.

Using the Experience Sampling Method to Examine the Details of Dosage in School-Based Speech Sound Therapy.

PURPOSE: The purpose of this project was to collect practice-based evidence regarding dosage in speech sound therapy sessions in school-based settings. Dosage is the number of trials within a therapy session for any one particular child. School-based speech-language pathologists (SLPs) face a variety of obstacles to service delivery, often making the implementation of evidence-based practices difficult. To that end, we were interested in exploring how therapy parameters, such as group size and session frequency were associated with dosage. METHOD: Using the experience sampling method, we queried school-based SLPs (n = 90) across the United States. SLPs participated via a phone application, which randomly alerted them to participate 3 times per day for 5 days. SLPs also completed a demographic questionnaire that included information regarding caseload size and job satisfaction. RESULTS: We report results from 670 therapy sessions. Results revealed that the therapy parameter of group size was negatively related to dosage. The SLP parameter of caseload size was positively related to dosage, but this was a small association. The child parameter of comorbidity was negatively related to dosage. CONCLUSIONS: Our results support that as group size increases, children receive smaller doses of speech sound practice. Similarly, children who have a reported comorbidity received smaller doses compared to children who have an isolated speech sound disorder. We discuss implications for school-based practitioners and researchers.

Consonant Cluster Productions in Preschool Children Who Speak African American English.

PURPOSE: The aim of this study was to compare word-initial and word-final consonant cluster productions in young children who speak African American English (AAE) and compare their productions to what we know about cluster productions in children who speak Mainstream American English (MAE), in order to minimize misdiagnosis of speech sound disorders. METHOD: Twenty-two children (ages 2;10-5;4 [years;months]) labeled pictures whose names contained at least one consonant cluster in word-initial and/or word-final position. Most two-element clusters of English were sampled, the majority in two or more words. The participants' responses were transcribed using a consensus transcription procedure. Each cluster attempt was analyzed for its similarity with MAE. RESULTS: Percentage matching scores were significantly higher for word-initial than word-final clusters. Word-final clusters produced as singletons were significantly more common than word-final cluster substitutions. However, word-initial cluster substitutions were significantly more common than word-initial clusters produced as singletons. Word-initial cluster mismatches were consistent with markedness theory and the sonority sequencing principle (SSP). By contrast, word-final cluster mismatches were not consistent with the SSP, while the voicing generalization seen in adult speakers of AAE was evident. CONCLUSION: Culturally and linguistically appropriate assessment of phonological development in children who speak AAE requires an understanding of the contrastive and noncontrastive features exemplified in their consonant cluster productions.

Advocacy Engagement and Self-Efficacy of School-Based Speech-Language Pathologists.

PURPOSE: The purpose of this study was to investigate advocacy engagement and self-efficacy of school-based speech-language pathologists (SLPs) and their perceptions of key issues in education and challenges to advocacy. METHOD: A 75-item survey was used to solicit information about advocacy-related experiences of 194 school-based SLPs. The survey included subsections on advocacy engagement, identity, training, and self-efficacy and solicited open-ended responses regarding perceived issues and hindrances. RESULTS: Results demonstrated low percentages of respondents had received training in advocacy (15%) and participated in an event (14%). A high percentage of respondents (45%) reported feeling ill-equipped to advocate but viewed their role as advocates to be important. Overall, respondents self-rated as moderately efficacious advocates. Age and perceived advocacy importance were significant predictors of self-efficacy. Frequently cited issues in education included lack of resources and support for educators and students, teachers' rights, and mental health. Common challenges to advocacy included time constraints, lack of knowledge and support, and fear of retaliation. CONCLUSIONS: Based on reported challenges to advocacy, more research is necessary to further investigate the extent these factors influence engagement and self-efficacy. As SLPs in this study viewed their advocacy role to be important but perceived themselves to be unprepared, additional training and professional development opportunities could support the degree to which SLPs engage in advocacy and perceive themselves to be effective advocates. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.19111532.

Change in School-Based Speech-Language Pathologists' Job Satisfaction During COVID-19 School Closures: Applying the Conservation of Resources Theory.

PURPOSE: The purpose of this investigation was to explore how school-based speech-language pathologists' (SLPs') job satisfaction changed because of the COVID-19 global pandemic. We situated job satisfaction within the Conservation Resources (COR) theory. METHOD: We distributed a web-based survey to school-based SLPs throughout the United States. A total of 1,352 SLPs followed the link and 1,069 completed at least 90% of the survey. The survey was composed of four parts: (a) demographic information, (b) obstacles faced during COVID-19 school closures, (c) job satisfaction, and (d) self-efficacy. Self-efficacy was divided into three subscales: decision-making, instructional, and disciplinary. RESULTS: Nearly half (48%, n = 522) of the sample reported a decline in job satisfaction following COVID-19 school closures. Using a binomial logistic regression, we found that time pressures and disciplinary self-efficacy predicted this change in job satisfaction. Individuals who reported higher disciplinary self-efficacy and more pressures on their time were 1.2 times more likely to experience a decline in job satisfaction. Number of obstacles faced, caseload size, years of experience, and the additional two self-efficacy scales were not related to this change. CONCLUSIONS: Job satisfaction is considered a malleable resource within the COR theory. Indeed, we observed a change in this resource due to the rapid shift in service delivery methods, paired with variable levels of support and resources from school districts. Our results have implications for how administration may support SLPs in and out of times of acute crises.

Which Speech Sound Norms Are Used in U.S. Public Schools? A Retrospective Survey Analysis.

Normative data concerning speech sound acquisition are widely and heavily used in the United States to determine eligibility for services. Normative studies differ in the age and geographic location of participants, which can limit applicability across the United States. In 2016, we queried school-based speech-language pathologists (SLPs) in the United States using a web-based survey to determine which speech sound norms are used. Nine regions from the U.S. census were represented. The Iowa-Nebraska norms were most commonly reported. However, many SLPs were unable to name the source of the data that they used. More than 60% of the sample indicated that they referred to one source of normative data. Results of a logistic regression indicated that region of the United States predicted if SLPs used one or multiple sources. Specifically, SLPs in the West North Central region of the United States (which includes Iowa and Nebraska) were more likely to use only one source of data, the Iowa-Nebraska norms. We recommend that speech sound norms are less heavily relied upon for eligibility decisions, particularly due to the substantial variations in culture and dialect throughout the various regions of the United States.

Factors that influence non-word repetition performance in children with and without persistent speech sound disorders.

BACKGROUND: Nonword repetition (NWR) is a common phonological processing task that is reported to tap into many cognitive, perceptual, and motor processes. For this reason, NWR is often used in assessment batteries to aid in verifying the presence of a reading or language disorder. AIMS: To examine the extent to which child- and item-level factors predict the probability of a correct response on a non-word repetition (NWR) task in a sample of children with persistent speech sound disorders (P-SSDs) compared with their typically developing peers. METHODS & PROCEDURES: A total of 40 American-English-speaking children were tested on an NWR task for which the stimuli were manipulated for phonological neighbourhood density and list length. Additional measures of vocabulary and word reading were also administered. OUTCOMES & RESULTS: Children who were typically developing were 1.82 times more likely than children with P-SSD to respond correctly. The item-level factor of phonological neighbourhood density influenced performance, but only for the P-SSD group, and only at certain list lengths. Vocabulary and word-reading ability also influenced NWR task performance. CONCLUSIONS & IMPLICATIONS: Children with P-SSD present as a complex and heterogeneous group. Multiple factors contribute to their ability to perform phonological tasks such as NWR. As such, attention to the item-level factors in screenings and assessments is necessary to ensure that appropriate decisions are made regarding diagnosis and subsequent treatment. WHAT THIS PAPER ADDS: What is already known on the subject? Good expressive vocabulary is important for children with speech sound disorders; it can aid in their performance on phonological processing tasks like NWR. Nonword repetition may be a helpful test/ subtest to add to assessment batteries when evaluating children with speech sound disorders. What this paper adds to existing knowledge? Vocabulary and word reading abilities must also be measured for children with SSDs, to observe the bigger picture of their linguistic abilities. What are the potential or actual clinical implications of this work? The relation between word reading and speech sound production influences performance on phonological processing tasks.

Reading Risk in Children With Speech Sound Disorder: Prevalence, Persistence, and Predictors.

Purpose The purpose of this study was to determine the extent to which school-age children with speech sound disorder (SSD) exhibit concomitant reading difficulties and examine the extent to which phonological processing and speech production abilities are associated with increased likelihood of reading risks. Method Data were obtained from 120 kindergarten, first-grade, and second-grade children who were in receipt of school-based speech therapy services. Children were categorized as being "at risk" for reading difficulties if standardized scores on a word decoding measure were 1 SD or more from the mean. The selected predictors of reading risk included children's rapid automatized naming ability, phonological awareness (PA), and accuracy of speech sound production. Results Descriptive results indicated that just over 25% of children receiving school-based speech therapy for an SSD exhibited concomitant deficits in word decoding and that those exhibiting risk at the beginning of the school year were likely to continue to be at risk at the end of the school year. Results from a hierarchical logistic regression suggested that, after accounting for children's age, general language abilities, and socioeconomic status, both PA and speech sound production abilities were significantly associated with the likelihood of being classified as at risk. Conclusions School-age children with SSD are at increased risk for reading difficulties that are likely to persist throughout an academic year. The severity of phonological deficits, reflected by PA and speech output, may be important indicators of subsequent reading problems.

Describing the Composition of Individualized Education Plans for Students With Traumatic Brain Injury.

Purpose The purpose of this study was to explore and describe the features of Individualized Education Plans (IEPs) for a cohort of students with traumatic brain injury (TBI) to help elucidate current special education practices for students with TBI. Method We obtained permission from administrators of a local school district of 41,000 students in a Midwestern state to review de-identified IEP records of students verified with TBI. We examined demographic information (i.e., cause and age at time of injury), IEP services and intensity, IEP goal categories, and previous verification status. Results Descriptive results support that intervention services were more intense for students with TBI with greater lengths of time postinjury. Target behaviors within goals were more often related to math and reading than to the cognitive processes that govern these skills, such as attention, memory, and executive functioning. Finally, more than a third of our sample had been verified with a disability and were receiving special education services via an IEP prior to their TBI. Conclusions This work represents an important first step in understanding the special education services for students with TBI. Future research should explore interventions that are ecologically valid for school-based settings and are developed to address the idiosyncratic deficits of students with TBI, particularly interventions that focus on the underlying cognitive processes experienced by these students.

Contributions to Gain in Speech Sound Production Accuracy for Children With Speech Sound Disorders: Exploring Child and Therapy Factors.

Purpose The purpose of this study was to explore the extent to which child- and therapy-level factors contribute to gains in speech sound production accuracy for children with speech sound disorders in receipt of school-based services. Method Data were obtained from 126 kindergarten and first- and second-grade children currently in receipt of speech therapy services in their public school setting. Pretest and posttest measures of spontaneous speech production and language ability were collected at the beginning and end of one academic year. Using a spontaneous speech sample, percentage of consonants correct (PCC) was calculated for each child; a gain score was computed by subtracting the pretest PCC score from the posttest PCC score. The children's speech-language pathologist completed weekly therapy logs during business-as-usual therapy, indicating the frequency, duration, and group composition of services throughout the school year. Results Results supported that gain in PCC from pretest to posttest was predicted by several child- and therapy-level variables. Children's initial speech sound severity was negatively related to gains in PCC. Our results also supported that the total number of therapy sessions received in a year was positively predictive of PCC gain. Interestingly, the number of individual therapy sessions was negatively associated with PCC gain. Conclusion Several malleable therapy factors contribute to gains in speech sound accuracy for children with speech sound disorders. Speech-language pathologists should consider how these factors may be manipulated to best tailor treatment to the individual needs of the children on their caseloads.