Access to Speech and Language Services and Service Providers for Children With Speech and Language Disorders.

OBJECTIVES: The purposes of this study were to (a) examine children's access to services for their speech and language disorders during their lifetimes; (b) identify any child, disorder, and family characteristics associated with access to services; and (c) describe the speech and language service providers among children who received care. STUDY DESIGN: Data from the 2012 National Health Interview Survey were used for this retrospective cohort study. Our sample included 491 children (ages 3;0-17;11 [years;months]) with speech disorders and 333 children with language disorders. We measured the receipt of services for speech or language difficulties (main outcome) and the type of professional providing services (secondary outcome). We examined associations between services and child, disorder, and family characteristics. RESULTS: Approximately 75% of children with speech and language disorders had ever received services for their difficulties. Privately insured children and children with co-occurring conditions were more likely to receive services than their peers who were uninsured (speech: 6.1 [1.7,21.3]; language: 6.6 [1.3,32.9]) and had no co-occurring conditions (speech: 2.1 [1.2,3.9]; language: 2.9 [1.5,5.5]). Speech-language pathologists (SLPs) were the most commonly reported provider of services (speech: 68%, language: 60%) followed by early interventionists. CONCLUSIONS: Most children with speech and language disorders received services. However, disparities existed by race/ethnicity, health insurance type, co-occurring diagnoses, and disorder duration (speech only). Most children who received services were being provided with care by the experts of speech and language: SLPs. Updated population-based data and implementation studies are needed to document speech and language screening, referral, and access to services. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.19799389.

Prologue: Implementation Science in CSD and Starting Where You Are.

In this prologue, we introduce readers to the Forum: Clinicians and Researchers Navigating Implementation Science in CSD. Implementation science (IS), or the study of the adoption of evidence-based practice in real-world settings, is a key area of development in communication sciences and disorders (CSD). The goal of this forum was to show by example how researchers and clinicians are collaborating to begin to apply IS in CSD. This goal culminated in a scoping review of IS in CSD, a tutorial on incorporating IS into clinical practice research, three articles on stakeholder engagement, and three examples of IS studies in CSD included in this forum. We hope this forum helps clinicians and researchers to begin wherever they are in their knowledge and understanding of IS in CSD.

Building Sustainable Models of Research-Practice Partnerships Within Educational Systems.

PURPOSE: To describe the 9-year journey of a group of language and literacy researchers in establishing and cultivating Research-Practice Partnerships (RPPs). Those interested in incorporating implementation science frameworks in their research may benefit from reading our exploration into this type of work and our lessons learned. METHOD: We showcase how a group of researchers, who are committed to collaboration with school practitioners, navigated building and scaling RPPs within educational systems necessary for our long-term implementation work. We provide details and illustrative examples for three, distinct, mutually beneficial, and sustainable partnerships. RESULTS: Three different practice organizations are represented: (1) a single metropolitan school, (2) a small metropolitan school district, and (3) a large metropolitan school district, highlighting specific priorities and needs depending on the type of practice organization. Each partnership has distinct research and practice goals related to improving language and literacy outcomes in children. We describe how the researchers assisted with meeting the partner practice organizations' goals and engaged in capacity building while producing rigorous scientific knowledge to inform clinical and educational practice. Additionally, we discuss how research priorities and strategies were pivoted in the past year due to the COVID-19 pandemic, illustrating our commitment to the partnerships and how to respond to challenges to guarantee long-term sustainability. CONCLUSION: By discussing three distinctive partnerships, we demonstrate the various ways researchers can approach RPPs and grow them into mutually beneficial collaborations and support implementation goals.

Integrating Morphological Awareness in a Multilinguistic Structured Literacy Approach to Improve Literacy in Adolescents With Reading and/or Language Disorders.

Purpose Reading and writing are language-based skills, and effective literacy instruction/intervention practices should include an explicit linguistic focus. A multilinguistic structured literacy approach that integrates morphological awareness is proven beneficial to improve reading and writing for students with language literacy deficits. The key components of this approach are explored. Method An intensive 2-week clinical summer camp, Camp CHRONICLE, which utilizes a multilinguistic structured literacy intervention model that integrates morphological awareness for adolescents with literacy deficits, is reviewed, and three case examples are included. Conclusion Multilinguistic structured literacy intervention with a morphological awareness focus is an ideal approach to improve literacy skills of children and adolescents with language literacy deficits. Supplemental Material https://doi.org/10.23641/asha.12291029.

Predicting Dyslexia in Children With Developmental Language Disorder.

Purpose In this study, we examine how well kindergarten letter identification and phonological awareness predict 2nd grade word reading and dyslexia in children with developmental language disorder (DLD) and their age- and grade-matched peers with typical language (TL). Method We employ (a) logistic regression to determine how letter identification and phonological awareness predict dyslexia, that is, dichotomous categorization of good or poor word reading, in children with DLD and TL and (b) quantile regression to determine how letter identification and phonological awareness are associated with word reading abilities on a continuum in these groups of children. Results Logistic regression revealed that letter identification was the only significant, unique kindergarten predictor of dyslexia in 2nd grade children with DLD, when compared to phonological awareness. In children with TL, both kindergarten letter identification and phonological awareness significantly predicted dyslexia in 2nd grade. Quantile regression revealed that kindergarten letter identification was a stronger predictor of 2nd grade word reading for average and lower achieving word readers with DLD and their peers with TL compared to higher performing readers. Phonological awareness was weakly associated with word reading across the full continuum of word reading abilities in children with DLD. Conclusion Letter identification is a more accurate predictor of poor word reading and dyslexia than phonological awareness in kindergarten children with DLD, which has important implications for recent U.S. legislation around early identification of dyslexia in all children.

Identifying Children at Risk for Developmental Language Disorder Using a Brief, Whole-Classroom Screen.

Purpose The aim of this study was to determine whether parents of children with developmental language disorder (DLD) were aware of their children's language difficulties and whether a brief, classroom-based language screen can reliably identify children at risk for DLD, including those with both good and poor word reading skills. Method First- and second-grade students ( N = 97) completed a language screen and assessments of nonverbal intelligence, word reading, and language designed for linguistically diverse students. Their parents completed a questionnaire. Results Few parents of children with DLD reported that their child had ever received speech, language, reading, or other educational services. Parents of children with DLD with average word reading skills reported receiving services approximately half as often as children with DLD with poor word reading. Parents of children with DLD also reported few concerns about their children's speech, language, and academic development. The brief whole-classroom screen showed acceptable classification accuracy for identifying children with DLD overall, although sensitivity was lower for children with DLD with average word reading skills. Conclusion Based on reports of prior services and concerns, many parents of children with DLD appear to be unaware of their children's difficulty with oral language. Whole-classroom screens for language show potential for efficient identification of children who may benefit from comprehensive assessments for DLD without relying on their parents or teachers to raise concerns.

On the importance of listening comprehension.

The simple view of reading highlights the importance of two primary components which account for individual differences in reading comprehension across development: word recognition (i.e., decoding) and listening comprehension. While assessments and interventions for decoding have been the focus of pedagogy in the past several decades, the importance of listening comprehension has received less attention. This paper reviews evidence showing that listening comprehension becomes the dominating influence on reading comprehension starting even in the elementary grades. It also highlights a growing number of children who fail to develop adequate reading comprehension skills, primarily due to deficient listening comprehension skills (i.e., poor comprehenders). Finally we discuss key language influences on listening comprehension for consideration during assessment and treatment of reading disabilities.