Effects of Speech Cues on Acoustics and Intelligibility of Korean-Speaking Children With Cerebral Palsy.

PURPOSE: Reduced speech intelligibility is often a hallmark of children with dysarthria secondary to cerebral palsy (CP), but effects of speech strategies for increasing intelligibility are understudied, especially in children who speak languages other than English. This study examined the effects of (the Korean translation of) two cues, "speak with your big mouth" and "speak with your strong voice," on speech acoustics and intelligibility of Korean-speaking children with CP. METHOD: Fifteen Korean-speaking children with CP repeated words and sentences in habitual, big mouth, and strong voice conditions. Acoustic analyses were performed and intelligibility was assessed by means of 90 blinded listeners' ease-of-understanding (EoU) ratings and percentage of words correctly transcribed (PWC). RESULTS: In response to both cues, children's vocal intensity and utterance duration increased significantly and differentially, whereas their vowel space area gains did not reach statistical significance. EoU increased significantly in the big mouth condition at word, but not sentence, level, whereas in the strong voice condition, EoU increased significantly at both levels. PWC increases were not statistically significant. Considerable variability in children's responses to cues was noted overall. CONCLUSIONS: Korean-speaking children with CP modify their speech styles differentially when provided with cues aimed to increase their articulatory working space and vocal intensity. The results provide preliminary support for the use of the strong voice cue, in particular, to increase EoU. While the findings do not offer conclusive evidence of the intelligibility benefits of these cues, investigation with a larger sample size should provide further insight into optimal cueing strategies for increasing intelligibility in this population. Implications for language-specific versus language-independent treatment approaches are discussed. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25521052.

"Take Us Into Account": Perspectives of Family Members of People With Parkinson's Disease Regarding Speech-Language Pathology Intervention.

PURPOSE: While communication changes associated with Parkinson's disease (PD) have been documented, research on the impact of these changes on family members is just beginning to emerge. With this new focus on family, questions arise as to how well speech-language pathology services address their needs communicating with their loved one with PD. The purpose of this study was to explore the experiences of family members of people with PD (PwPD) and their recommendations for speech-language pathology services that incorporated their needs. METHOD: Seventeen spouses/partners of PwPD participated in focus groups that were recorded, transcribed, and analyzed using thematic analyses. RESULTS: Three themes emerged, all focusing around the central tenet that the experiences of family members, and hence their need for speech-language pathology support, transitioned through the stages of PD progression. Theme 1 summarized increasing burdens on family to manage communication as PD progressed beyond a brief period of independent strategy use by PwPD. Theme 2 highlighted multifactorial contributors to communication burdens on families, with cognitive impairments being the most underrecognized. Theme 3 illustrated how families wanted more intervention options from speech-language pathologists (SLPs) that included them, but with a tailored approach for PD stages and personal preferences. CONCLUSIONS: When SLPs provide families with either generic communication strategies or strategies that do not fit the individualized needs of PwPD and their families, we may inadvertently be increasing the burden on families. There is a need for systematic, evidence-based, family-centered interventions that include, but go beyond, current speech-focused interventions to meet the shared communication needs of PwPD and their families.

A qualitative study of reflective practice in the workplace. Speech-language pathologists have their say.

PURPOSE: Engaging in reflective practice (RP) and demonstrating reflective abilities is an essential graduate skill for speech-language pathologists (SLPs), yet limited studies have examined the perspectives of practicing SLPs and how and why they engage in RP. This qualitative study aimed to examine SLPs' experiences and perspectives of RP in diverse workplaces. METHOD: Individual semi-structured interviews were conducted with 30 SLPs working in health, education, or private practice sectors. Interviews were analysed using thematic analysis. RESULT: Three themes were developed from the data, describing what SLPs use RP for, what SLPs perceive as important in order to engage in RP in the workplace, as well as the barriers they have identified, and how SLPs have observed a change in engaging in RP as they have progressed in their careers. CONCLUSION: SLPs described that RP is valued in the workplace for supporting client focused care, problem-solving, and lifelong learning. SLPs wanted time to be protected for RP at all stages of their career and valued the relationships with others as contributing positively to RP. Perceptions of and engagement in RP changed in relation to SLPs' clinical experience. Implications for clinical practice are discussed.

Lexical-semantic properties of verbs and nouns used in conversation by people with Alzheimer's disease.

Alzheimer's disease (AD) is accompanied by language impairments and communicative breakdowns. Research into language processing by people with AD (pwAD) has focused largely on production of nouns in isolation. However, impairments are consistently found in verb production at word and sentence levels, and comparatively little is known about word use by pwAD in conversation. This study investigated differences between pwAD and cognitively healthy controls in conversational use of nouns, verbs, and pronouns. Speech samples produced by 12 pwAD and 12 controls for the Carolinas Conversations Collection were analysed for noun, verb and pronoun counts and ratios, lexical diversity overall and among nouns and verbs, copula use, and frequencies and ages of acquisition (AoA) of nouns and verbs produced. pwAD used fewer nouns and a narrower range of words than controls, exhibiting signs of increased reliance on pronouns and decreased noun diversity. Age affected noun frequencies differently within each group-pwAD produced nouns of lower frequencies with age, while controls produced nouns of higher frequencies. pwAD produced nouns of higher AoA than controls. Verb use differed little by group. These findings highlight the need to account for differences between nouns and verbs, including in frequency, AoA, proportion of all words spoken, and context-dependent processing demands, when drawing conclusions on language use by pwAD. They also suggest potential for communicative interventions targeting contextual use of both nouns and verbs.

Acquired Stuttering in Parkinson's Disease.

Background: Parkinson's disease frequently causes communication impairments, but knowledge about the occurrence of new-onset stuttering is limited. Objectives: To determine the presence of acquired neurogenic stuttering and its relationship with cognitive and motor functioning in individuals with Parkinson's disease. Method: Conversation, picture description, and reading samples were collected from 100 people with Parkinson's disease and 25 controls to identify the presence of stuttered disfluencies (SD) and their association with neuropsychological test performance and motor function. Results: Participants with Parkinson's disease presented with twice as many stuttered disfluencies during conversation (2.2% ± 1.8%SD) compared to control participants (1.2% ± 1.2%SD; P < 0.01). 21% of people with Parkinson's disease (n = 20/94) met the diagnostic criterion for stuttering, compared with 1/25 controls. Stuttered disfluencies also differed significantly across speech tasks, with more disfluencies during conversation compared to reading (P < 0.01). Stuttered disfluencies in those with Parkinson's disease were associated with longer time since disease onset (P < 0.01), higher levodopa equivalent dosage (P < 0.01), and lower cognitive (P < 0.01) and motor scores (P < 0.01). Conclusion: One in five participants with Parkinson's disease presented with acquired neurogenic stuttering, suggesting that speech disfluency assessment, monitoring and intervention should be part of standard care. Conversation was the most informative task for identifying stuttered disfluencies. The frequency of stuttered disfluencies was higher in participants with worse motor functioning, and lower cognitive functioning. This challenges previous suggestions that the development of stuttered disfluencies in Parkinson's disease has purely a motoric basis.

Acoustic Predictors of Ease of Understanding in Spanish Speakers With Dysarthria Associated With Parkinson's Disease.

PURPOSE: The purpose of this study was to examine selected baseline acoustic features of hypokinetic dysarthria in Spanish speakers with Parkinson's disease (PD) and identify potential acoustic predictors of ease of understanding in Spanish. METHOD: Seventeen Spanish-speaking individuals with mild-to-moderate hypokinetic dysarthria secondary to PD and eight healthy controls were recorded reading a translation of the Rainbow Passage. Acoustic measures of vowel space area, as indicated by the formant centralization ratio (FCR), envelope modulation spectra (EMS), and articulation rate were derived from the speech samples. Additionally, 15 healthy adults rated ease of understanding of the recordings on a visual analogue scale. A multiple linear regression model was implemented to investigate the predictive value of the selected acoustic parameters on ease of understanding. RESULTS: Listeners' ease of understanding was significantly lower for speakers with dysarthria than for healthy controls. The FCR, EMS from the first 10 s of the reading passage, and the difference in EMS between the end and the beginning sections of the passage differed significantly between the two groups of speakers. Findings indicated that 67.7% of the variability in ease of understanding was explained by the predictive model, suggesting a moderately strong relationship between the acoustic and perceptual domains. CONCLUSIONS: Measures of envelope modulation spectra were found to be highly significant model predictors of ease of understanding of Spanish-speaking individuals with hypokinetic dysarthria associated with PD. Articulation rate was also found to be important (albeit to a lesser degree) in the predictive model. The formant centralization ratio should be further examined with a larger sample size and more severe dysarthria to determine its efficacy in predicting ease of understanding.

Improving healthcare quality for transgender patients in the perioperative setting: The patient's perspective.

Transgender individuals reported higher rates of discrimination and barriers to care within healthcare settings than their cisgender counterparts. There is a paucity of literature concerning the barriers experienced within perioperative healthcare settings. Participants completed a sociodemographic questionnaire and a 7-item Likert-type scale survey: the Everyday Discrimination Scale Adapted for Medical Settings. Overall, 57% of trans-individuals who underwent gender-affirming surgery reported perceptions of discrimination when interacting with healthcare providers within the perioperative setting according to responses from the Discrimination in Medical Settings Survey. There was an overall difference in the summary scores between participants based on gender transition. These findings highlight an opportunity to address barriers to care related to discrimination and negative patient-provider interactions. These findings have implications for the development and integration of patient-informed, evidence-based, trans-specific, educational and cultural competency trainings to enhance the healthcare professional's knowledge, attitudes, comfort and ability to care for the transgender population.Key phrases: Transgender individuals reported higher rates of discrimination and barriers to care; enhancing the healthcare professional's knowledge, attitudes, comfort and ability to care for the transgender population; opportunities to address barriers to care related to discrimination and negative patient-provider interactions; individuals who transitioned from male-to-female (MTF) had higher scores related to perceptions of discrimination during interactions with healthcare providers.

Written reflective practice abilities of SLT students across the degree programme.

BACKGROUND: Written reflective practice (WRP) is a teaching tool used across speech-language therapy (SLT) clinical education programmes. The process aims to support the development of reflective skills required for the workplace (e.g., problem-solving and self-evaluation). AIMS: This cross-sectional and repeated-measures study design investigated students' demonstration of breadth of WRP across the clinical education programme. METHODS & PROCEDURES: The participants were 77 undergraduate SLT students in their first, second or final professional year of the clinical programme. Participants wrote critical reflections following an interaction with a client/s as part of their clinical education experiences. Formative feedback was provided after each written reflection (WR). In total four WRs per participant were coded for breadth of WRP using a modification of Plack et al.'s coding schema from 2005. This was completed for each of the four time points across the academic year for each professional year. OUTCOMES & RESULTS: There was a statistically significant association between time (i.e., professional year of the programme) and likelihood of demonstration of breadth of reflection for the lower level reflective element of 'attend' and higher level reflective element of 're-evaluate'. A positive trend between time and likelihood of demonstration of breadth of reflection was seen for the lower level element of 'reflection-for-action'. Final-professional-year students exhibited significant enhancements in the higher level elements (e.g., 'premise') compared with first- and second-professional-year students. CONCLUSIONS & IMPLICATIONS: This group of SLT students exhibited significant change in breadth of WRP across the degree programme. This finding has positive implications for facilitating WRP with students and using the current coding framework in clinical programmes. WHAT THIS PAPER ADDS: What is already known on this subject WRP is one form of reflective practice (RP) used in SLT, allied health, medical and nursing clinical education programmes. Researchers have suggested that RP skills develop over time for students. Previously, studies examining WRP have focused on one off assessment of skill or over a timeframe of 6-10 weeks. Here, we examine SLT students' WRP skills across the degree programme. What this paper adds to existing knowledge SLT students exhibited significant positive change in breadth of WRP across the degree programme as their clinical experience increased. Our results provide quantitative information in support of using RP as a learning tool throughout clinical education programmes for SLT. What are the potential or actual clinical implications of this work? This study offers support for educators of SLT students; for example, how educators can assess WRP, and how educators can foster SLT student skill development with formative feedback and reflective questioning. This study also offers support for student SLT, for example, describing how WRP can be part of their individualized learning approach and provide a purposeful examination of self and clinical skill development.

The Effects of Intensive Voice Treatment in Mandarin Speakers With Parkinson's Disease: Acoustic and Perceptual Findings.

PURPOSE: This study investigated the effects of intensive voice treatment on subjective and objective measures of speech production in Mandarin speakers with hypokinetic dysarthria. METHOD: Nine Mandarin speakers with hypokinetic dysarthria due to Parkinson's disease received 4 weeks of intensive voice treatment (4 × 60 min per week). The speakers were recorded reading a passage before treatment (PRE), immediately after treatment (POST), and at 6-month follow-up (FU). Listeners (n = 15) rated relative ease of understanding (EOU) of paired speech samples on a visual analogue scale. Acoustic analyses were performed. Changes in EOU, vocal intensity, global and local fundamental frequency (f o) variation, speech rate, and acoustic vowel space area (VSA) were examined. RESULTS: Increases were found in EOU and vocal intensity from PRE to POST and from PRE to FU, with no change found from POST to FU. Speech rate increased from PRE to POST, with limited evidence of an increase from PRE to FU and no change from POST to FU. No changes in global or local f o variation or in VSA were found. CONCLUSIONS: Intensive voice treatment shows promise for improving speech production in Mandarin speakers with hypokinetic dysarthria. Vocal intensity, speech rate, and, crucially, intelligibility, may improve for up to 6 months posttreatment. In contrast, f o variation and VSA may not increase following the treatment. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.19529017.

Language changes in Alzheimer's disease: A systematic review of verb processing.

Alzheimer's disease (AD) results in language impairments and higher-level communication problems. Research into the language of people with AD (pwAD) has mainly focused on nouns; however, improved understanding of verb processing by pwAD could improve diagnostic assessments and communicative interventions. This systematic review synthesizes findings of AD's effects on verbs from single-word, sentence, and discourse tasks. Review of 57 studies revealed that pwAD were less accurate than controls on single-word tasks and less accurate with verbs than nouns on these tasks. They had difficulty comprehending sentences featuring multiple verbs or verbs with reversible thematic roles. Discourse production by pwAD was marked by vagueness, including declines in total output and propositional content and a preference for generic verbs and simple syntax. Few studies examining sentence production or discourse comprehension were found. Future research should address relationships between long-term memory and language preservation as well as verb use in discourse.

Redeployment of Certified Registered Nurse Anesthetists During the Coronavirus Disease 2019 Pandemic.

Certified Registered Nurse Anesthetists (CRNAs) are uniquely skilled anesthesia providers with substantial experience managing critically ill patients. During the coronavirus disease 2019 (COVID) pandemic, CRNAs at a large academic medical center in the Mid-Atlantic United States experienced a shift in their daily responsibilities. As the hospital transitioned to the management of patients who tested positive for the virus that causes COVID, the severe acute respiratory syndrome-coronavirus type 2 (SARS-CoV-2), CRNAs were redeployed into the roles of respiratory therapists and intensive care unit registered nurses. Although facing the stress of the global pandemic, this facility's CRNAs proved to be flexible, capable, and necessary members of the care team for patients with COVID-19.

Perceptual and Acoustic Effects of Dual-Focus Speech Treatment in Children With Dysarthria.

Purpose Children with dysarthria secondary to cerebral palsy may experience reduced speech intelligibility and diminished communicative participation. However, minimal research has been conducted examining the outcomes of behavioral speech treatments in this population. This study examined the effect of Speech Intelligibility Treatment (SIT), a dual-focus speech treatment targeting increased articulatory excursion and vocal intensity, on intelligibility of narrative speech, speech acoustics, and communicative participation in children with dysarthria. Method American English-speaking children with dysarthria (n = 17) received SIT in a 3-week summer camplike setting at Columbia University. SIT follows motor-learning principles to train the child-friendly, dual-focus strategy, "Speak with your big mouth and strong voice." Children produced a story narrative at baseline, immediate posttreatment (POST), and at 6-week follow-up (FUP). Outcomes were examined via blinded listener ratings of ease of understanding (n = 108 adult listeners), acoustic analyses, and questionnaires focused on communicative participation. Results SIT resulted in significant increases in ease of understanding at POST, that were maintained at FUP. There were no significant changes to vocal intensity, speech rate, or vowel spectral characteristics, with the exception of an increase in second formant difference between vowels following SIT. Significantly enhanced communicative participation was evident at POST and FUP. Considerable variability in response to SIT was observed between children. Conclusions Dual-focus treatment shows promise for improving intelligibility and communicative participation in children with dysarthria, although responses to treatment vary considerably across children. Possible mechanisms underlying the intelligibility gains, enhanced communicative participation, and variability in treatment effects are discussed.

Comparing Lexical Cues in Listener Processing of Dysarthria and Speech in Noise.

Purpose The frequency of a word and its number of phonologically similar neighbors can dramatically affect how likely it is to be accurately identified in adverse listening conditions. This study compares how these two cues affect listeners' processing of speech in noise and dysarthric speech. Method Seven speakers with moderate hypokinetic dysarthria and eight healthy control speakers were recorded producing the same set of phrases. Statements from control speakers were mixed with noise at a level selected to match the intelligibility range of the speakers with dysarthria. A binomial mixed-effects model quantified the effects of word frequency and phonological density on word identification. Results The model revealed significant effects of word frequency (b = 0.37, SE = 0.12, p = .002) and phonological neighborhood density (b = 0.40, SE = 0.12, p = .001). There was no effect of speaking condition (i.e., dysarthric speech vs. speech in noise). However, a significant interaction was observed between speaking condition and word frequency (b = 0.26, SE = 0.04, p < .001). Conclusions The model's interactions indicated that listeners were more strongly influenced by the effects of word frequency when decoding moderate hypokinetic dysarthria as compared to speech in noise. Differences in listener reliance on lexical cues may have important implications for the selection of communication-based treatment strategies for speakers with dysarthria.

The Effects of Word Frequency and Word Probability on Speech Rhythm in Dysarthria.

Purpose In healthy speakers, the more frequent and probable a word is in its context, the shorter the word tends to be. This study investigated whether these probabilistic effects were similarly sized for speakers with dysarthria of different severities. Method Fifty-six speakers of New Zealand English (42 speakers with dysarthria and 14 healthy speakers) were recorded reading the Grandfather Passage. Measurements of word duration, frequency, and transitional word probability were taken. Results As hypothesized, words with a higher frequency and probability tended to be shorter in duration. There was also a significant interaction between word frequency and speech severity. This indicated that the more severe the dysarthria, the smaller the effects of word frequency on speakers' word durations. Transitional word probability also interacted with speech severity, but did not account for significant unique variance in the full model. Conclusions These results suggest that, as the severity of dysarthria increases, the duration of words is less affected by probabilistic variables. These findings may be due to reductions in the control and execution of muscle movement exhibited by speakers with dysarthria.

Predicting Montreal Cognitive Assessment Scores From Measures of Speech and Language.

Purpose This study examined the relationship between measurements derived from spontaneous speech and participants' scores on the Montreal Cognitive Assessment. Method Participants (N = 521) aged between 64 and 97 years completed the cognitive assessment and were prompted to describe an early childhood memory. A range of acoustic and linguistic measures was extracted from the resulting speech sample. A least absolute shrinkage and selection operator approach was used to model the relationship between acoustic, lexical, and demographic information and participants' scores on the cognitive assessment. Results Using the covariance test statistic, four important variables were identified, which, together, explained 16.52% of the variance in participants' cognitive scores. Conclusions The degree to which cognition can be accurately predicted through spontaneously produced speech samples is limited. Statistically significant relationships were found between specific measurements of lexical variation, participants' speaking rate, and their scores on the Montreal Cognitive Assessment.

Hearing ability is not a risk factor for admission to aged residential care of older persons in New Zealand.

Aged residential care (ARC) admission needs are increasing beyond the available capacity in many countries, including New Zealand. Therefore, identifying modifiable factors which may prevent or delay ARC admissions is of international importance. Hearing impairment is common among older adults and thought to be an important predictor, although the current evidence-base is equivocal. Using the largest national database to date, competing-risk regression analysis was undertaken on 34,277 older adults having standardised home care assessments between 1 July 2012 and 31 May 2014, aged ≥65 years, and still living in the community 30 days after that assessment. Minimal hearing difficulty was reported by 10,125 (29.5%) participants, moderate difficulty by 5,046 (14.7%), severe difficulty/no hearing by 1,334 (3.9%), while 17,769 (51.8%) participants reported adequate hearing. By 30 June 2014, the study end-point, 6,389 (18.6%) participants had an ARC admission while 6,082 (17.7%) had died. In unadjusted competing-risk regression analyses, treating death as a competing event, hearing ability was significantly associated with ARC admission (p < 0.001). However, in adjusted analyses, this relationship was completely confounded by other variables (p = 0.67). This finding implies that screening for hearing loss among community-living older adults is unlikely to impact on ARC admission rates.

Examining Listener Reaction Time in the Perceptual Assessment of Dysarthria.

OBJECTIVE: In the perceptual assessment of dysarthria, various approaches are used to examine the accuracy of listeners' speech transcriptions and their subjective impressions of speech disorder. However, less attention has been given to the effort and cognitive resources required to process speech samples. This study explores the relationship between transcription accuracy, comprehensibility, subjective impressions of speech, and objective measures of reaction time (RT) to further examine the challenges involved in processing dysarthric speech. PATIENTS AND METHODS: Sixteen listeners completed 3 experimental listening tasks: a sentence transcription task, a rating scale task, and an RT task that required responses to veracity statements. In each task, the speech stimuli included speech from 8 individuals with dysarthria. RESULTS: Measurements from the 3 tasks were significantly related, with a correlation coefficient of -0.94 between average RT and transcription-based intelligibility scores and -0.89 between RT and listener ratings of dysarthria. Interrater reliability of RT measurements was relatively low when considering a single person's response to stimuli. However, reliability reached an acceptable level when a mean was taken from 8 listeners. CONCLUSIONS: RT tasks could be developed as a reliable adjunct in the assessment of listener effort and speech processing.

Acoustic and Perceptual Consequences of Speech Cues for Mandarin Speakers With Parkinson's Disease.

Purpose This study investigated the effects of cueing for increased loudness and reduced speech rate on scaled intelligibility and acoustics of speech produced by Mandarin speakers with hypokinetic dysarthria due to Parkinson's disease (PD). Method Eleven speakers with PD read passages in habitual, loud, and slow speaking conditions. Fifteen listeners rated ease of understanding (EOU) of the speech samples on a visual analog scale. Effects of the cues on EOU, vocal loudness, pitch range, pause duration and frequency, articulation rate, and vowel space, as well as relationships between EOU gains and acoustic features, were analyzed. Results EOU increased significantly in the loud condition only. The loud cue resulted in increased intensity, and the slow cue resulted both in reduced articulation rate and increased pause frequency. In the loud condition, EOU increased significantly as intensity increased and vowel centralization decreased. In the slow condition, EOU tended to increase as intensity increased and vowel centralization decreased but did not reach statistical significance. Conclusion Cueing for loud speech may yield greater EOU gains than cueing for slow speech in Mandarin speakers with PD. Theoretical and clinical implications are discussed, although further investigations with more participants and a larger range of dysarthria severity are warranted.

Assessing and developing the written reflective practice skills of speech-language pathology students.

PURPOSE: Written reflective practice aims to support critical thinking and problem solving skills in speech-language pathology (SLP) clinical education programmes. Yet, there has been limited investigation of students' development of written reflective practice skills over time and during a real-time clinical experience. The purpose of this study was to investigate students' development of breadth and depth of written reflective practice across a six-week clinical experience. METHOD: Participants were 59 undergraduate and 14 postgraduate SLP students. Participants wrote critical reflections describing an interaction with a client/s at the conclusion of weeks two, four and six of their clinical experience. Formative feedback was provided after each submission. Breadth and depth of reflection were coded using a modification of Plack et al.'s coding schema. RESULT: There was a statistically significant association between time and likelihood of development of breadth of reflection for the elements process and content. Depth of reflection improved significantly across time. The majority of participants were classified as "reflectors" or critical reflector at the conclusion of the study. CONCLUSION: SLP students can make significant improvements in both breadth and depth of written reflective practice over a six-week period. Implications for clinical teaching are discussed.

An epidemiological profile of communication disability among older adults with complex needs: A national cross-sectional study.

Purpose: Research on the prevalence of communication disability among community living older adults is scant, and often suffers from limitations. Using a national database, this study presents an epidemiological profile of communication disability in older community residents within New Zealand and examines whether ethnic populations are disproportionately represented.Method: Since 2012, all New Zealand community care recipients have undergone a standardised needs assessment, which includes questions directed at expressive and receptive language abilities. Those assessed between 1 September 2012 and 31 January 2016, aged ≥65 years, and who provided consent were included. Directly standardised prevalence estimates were calculated and logistic regression used to investigate age, sex and ethnic differences.Result: Overall, 71 859 people were eligible (mean age = 82.7 years, 61% female, 89.2% European/other), with 30.6% and 36.2% exhibiting at least some expression and comprehension communication disability, respectively. Maori, Pasifika and Asian people, males and those who were older were more likely to have at least some communication disability compared to their European/other, female and younger counterparts.Conclusion: Communication disability is common among older adults. With the increased provision of home-based integrated models of care, the impact of communication disability on service seeking and delivery must be recognised and accommodated.