The Impact of Videofluoroscopic Pulse Rate on Duration and Kinematic Measures in Infants and Adults with Feeding and Swallowing Disorders.

This investigation assessed the impact of temporal resolution during a videofluoroscopic evaluation of swallowing (VFSS) on measures of duration and kinematics. Thirty adult and ten infant swallow studies, all acquired at 30 frames and 30 pulses per second, were obtained from a New Mexico hospital. All swallow studies were altered to simulate 15 and 5 pulses per second. Duration measures included pharyngeal response time, duration of upper esophageal sphincter (UES) opening, velopharyngeal closure duration and total swallow duration. Kinematic measures were assessed in adults only and included peak hyoid position and extent of UES opening during the swallow. Analysis of outcome measures was performed and compared across the three temporal resolutions (30, 15, and 5 pulses per second). For data points where normative values are available, we evaluated the impact of temporal resolution on clinical determination (i.e., did a change in pulse rate alter the clinical classification). Kinematic and duration measures were altered with changes in pulse rate and these changes increased as temporal resolution decreased. For outcome measures where normative values are available, accuracy of clinical determination decreased with decreased pulse rate. Temporal resolution impacts duration and kinematic measures. However, the direction of these changes is unpredictable, indicating sensitivity and specificity are both affected. Without a predictable impact, the use of lower pulse rates may alter clinical impressions and treatment recommendations yielding inappropriate treatment goals and treatment duration.

Ethically Responsible Participant Selection in Research: A Viewpoint.

PURPOSE: The American Speech-Language-Hearing Association (ASHA) has committed to advancing diversity, equity, and inclusion (DEI) in the profession of speech and hearing sciences. However, there exist significant discrepancies between the demographics of our members and the populations served. These discrepancies extend to the participants included within our research publications. This article addresses participant selection when conducting research investigations. First, we draw attention to standards of conduct that are present within and outside the field. Second, we highlight inequities that exist. We explore a case study as an example. Finally, we offer suggestions to help rectify the problem. CONCLUSIONS: Inequities at the level of participants' selection result in discrepant access to clinical services and evidence-based research for multilingual individuals; neurodiverse individuals; and Black, Indigenous, and people of color communities. ASHA and researchers alike can show commitment to DEI by addressing this problem from multiple approaches.

A Complexity Approach to Promoting Within- and Cross-Language Generalization in Bilingual Children With Phonological Delays.

PURPOSE: The purpose of this study was to explore the effects of generalization when treating complex targets with shared sounds in Spanish for a 5-year-old Spanish-English bilingual child with a phonological delay. METHOD: Two complex clusters (/fl/ and /fɾ/) and one additional target (/l/) were chosen for treatment. Intervention sessions were held in Spanish over the course of 1 year on a weekly basis. The accuracy of the treated and untreated targets was monitored using a single-subject case design and was assessed using visual analysis. RESULTS: The accuracy of the production of treated targets increased upon administering the intervention. Accuracy also increased for untreated /fl/ targets in Spanish and English, /l/ in English, and untreated /fɾ/ clusters in Spanish. CONCLUSIONS: The results suggest that choosing complex targets consisting of shared sounds helps promote the generalization of skills within and across languages. Future studies should examine the outcomes of selecting additional forms of complex targets for bilingual children.