Rapid transition to telepractice across the lifespan in speech-language pathology: Insight from a survey of clinicians in Canada.

PURPOSE: This study aims to describe the experiences and needs of Canadian speech-language pathologists (SLPs) who conducted communication assessments via telepractice across the lifespan during the first year (2020) of the COVID-19 pandemic. METHOD: The present study consisted of an online survey that aimed to capture both quantitative aspects of telepractice-based communication assessment and the qualitative experience of shifting to telepractice. One hundred sixty-eight practicing SLPs across Canada participated in the survey, between September 2020 and January 2021. Quantitative results were analysed using descriptive statistics while open-ended responses were analysed using thematic analysis. RESULT: SLPs identified challenges and opportunities relating to client and family engagement, access to and knowledge of technology, and the reliability of assessment tools. SLPs also identified a future need for online assessment materials and training, such as materials adapted for different communication needs (e.g. augmentative and alternative communication). CONCLUSION: The present study contributes to a growing understanding worldwide of potential benefits and challenges related to telepractice, fuelled by the necessary shift in practices in our field during the COVID-19 pandemic. The results provide direction for continuing to build a valid and inclusive approach to telepractice in the future.

A scoping review of oral language and social communication abilities in children with Tourette syndrome.

BACKGROUND: Children with Tourette syndrome (TS) have historically experienced problems in academic and social settings, yet their language and communication abilities have not been extensively researched. AIMS: This scoping review maps the literature on the oral language and social communication abilities of children with TS in order to describe the nature of the current literature, present a summary of major findings and identify where gaps exist. METHODS: A scoping review was completed to identify studies measuring the oral language or social communication abilities of children with TS. A systematic search of six electronic databases was conducted to obtain published and unpublished literature. All English studies measuring the oral language or social communication abilities of children with TS were included. Information was extracted from records and knowledge was synthesised in a narrative summary. MAIN CONTRIBUTION: We identified 56 records for inclusion. Almost all records were located in journals within the fields of psychology and psychiatry. Skills most often studied were verbal IQ and verbal fluency. The literature suggests an increased prevalence of language disorders and social communication problems in children with TS; however, literature comprehensively detailing these challenges was scarce. Language strengths were identified in verbal intelligence, story/sentence recall, categorisation and performance on tasks at the single-word level. CONCLUSIONS: Oral language and social communication skills are important for academic and social success. This review brings scattered literature together to provide up-to-date information about language in children with TS and highlights that there are considerable gaps in our knowledge about language and communication in this population. This scoping review can inform future research and support speech language pathologists in the assessment of young people with TS. WHAT THIS PAPER ADDS: What is already known on the subject Speech-language pathologists (SLPs) working in various contexts (e.g., schools, mental health teams) are likely to encounter children with Tourette syndrome (TS); however, the description of this population and potential communication characteristics is not well represented in the SLP literature. Previous literature reviews have reported strengths in verbal fluency and morphological processing. Challenges in expressive language, higher order language, social cognition and a propensity towards autistic traits have also been identified. What this paper adds to existing knowledge This review differs from previous narrative reviews by employing a systematic approach to searching for literature. As a result, we identified 25 additional studies that had not been cited in previous reviews and additional relevant findings in 23 previously reviewed studies. This review confirms several previous conclusions about language in children with TS and extends or clarifies several others, thereby providing the most current information on oral language and social communication abilities. The use of current taxonomies of language and social communication helps to organise this literature for clinicians and researchers in speech-language pathology and identifies a need for further research from the SLP perspective. What are the potential or actual clinical implications of this work? These results imply that SLPs should screen children with TS for language disorders and investigate social communication and social interaction development. Clinicians can expect greater challenges in language and communication development for children with complex forms of TS (i.e., those who exhibit co-occurring conditions such as attention-deficit/hyperactivity disorder). The multidisciplinary nature of the current literature implies that clinical collaboration with other disciplines will be of particular benefit to serving this group of children.

Monolingual and bilingual children's production of complex syntactic structures.

Typically-developing bilingual children often score lower than monolingual peers of the same age on standardized measures; however, research has shown that when assessed in more natural discourse contexts, bilinguals can perform similar to age-matched monolinguals in some language subdomains. This study investigated complex syntax production in simultaneous French-English bilingual children and monolingual age-matched peers, using structured and spontaneous measures. Surprisingly, the bilinguals scored higher than the monolinguals on the structured task. There was no difference between groups on the spontaneous measure; however, predictors of complex syntax production differed by language groups and by tasks. Contrary to other language subdomains showing bilingual English development as protracted relative to monolingual peers, these results point to a relative strength of complex syntax acquisition among simultaneous bilingual children. Differences in exposure relative to monolingual children may be less pronounced in syntax, in part because bilinguals can benefit from syntactic knowledge in their other language.

Cumulative semantic interference across unrelated responses in school-age children's picture naming.

Naming semantically related images results in progressively slower responses as more images are named. There is considerable documentation in adults of this phenomenon, known as cumulative semantic interference. Few studies have focused on this phenomenon in children. The present research investigated cumulative semantic interference effects in school-aged children. In Study 1, children named a series of contiguous, semantically related pictures. The results revealed no cumulative interference effects. Study 2 utilized an approach more closely aligned with adult methods, incorporating intervening, unrelated items intermixed with semantically related items within a continuous list. Study 2 showed a linear increase in reaction time as a function of ordinal position within semantic sets. These findings demonstrate cumulative semantic interference effects in young, school-aged children that are consistent with experience-driven changes in the connections that underlie lexical access. They invite further investigation of how children's lexical representation and processing are shaped by speaking experiences.

Properties of Lexical Diversity in the Narratives of Children With Typical Language Development and Developmental Language Disorder.

Purpose We examined four measures of lexical diversity in the narratives of children with typical language development (TLD) and developmental language disorder (DLD) that comprised the normative sample of the Edmonton Narrative Norms Instrument (Schneider et al., 2005). The purpose was to document the properties of each measure with respect to variations in utterance and sample length, developmental trends, and group differences. Method The sample consisted of 377 picture-elicited, story generation transcripts from children with TLD (n = 300) and DLD (n = 77) aged 4-9 years. We extracted the moving-average type-token ratio (MATTR) and the number of different words from the full sample, from samples equated for the number of utterances, and from samples equated for the total number of words. Results MATTR was the only measure to show no relationships to utterance or sample length. All measures showed significant positive growth with age and significant groupwise differences between children with TLD and DLD. However, the magnitude of age effects and differentiation between groups varied considerably across measures. Across measures, there were significant differences in the number of children with DLD who were identified with low lexical diversity relative to their same-age peers in the TLD group. Conclusion The results of this study support the view that different measures of lexical diversity may be appropriate for different clinical purposes. It is important for clinicians to understand how measures of lexical diversity function in order to make educated choices among measures and ensure appropriate interpretation.

Lexical Diversity Versus Lexical Error in the Language Transcripts of Children With Developmental Language Disorder: Different Conclusions About Lexical Ability.

Purpose The purpose of this study was to provide preliminary data on differences in lexical diversity and lexical-semantic errors in the language samples of children with developmental language disorder (DLD) and children with typical language development (TLD) of the same age. Method We analyzed word use in the narrative transcripts of children with DLD and TLD (N = 14; M age = 6;8 [years;months]) using standard measures of lexical diversity (number of different words, moving-average type-token ratio) and additional counts of lexical-semantic errors. Results There were no significant differences between the groups in lexical diversity, and all children with DLD scored within the age-appropriate range on diversity relative to a normative sample. The children with DLD, however, produced significantly more lexical errors than their TLD peers. Conclusions The results suggest that caution is warranted when interpreting normal-range lexical diversity scores in children with DLD, as children with DLD may demonstrate functional difficulties with word use that are not captured by lexical diversity measures. A focus on lexical errors holds promise for characterizing lexical-semantic qualities of language transcripts that are not captured by standard measures of diversity. Development of a reliable clinical system for coding and characterizing lexical-semantic errors in language transcripts is warranted.

Effects of target attributes on children's patterns of referential under- and over-specification.

We examined the effects of object attributes on children's descriptive patterns in a referential communication task. Thirty preschoolers described object pairs that were selected by the experimenter. The targets were defined by shared size or colour, and differed on the non-target dimension in half of the trials. The children also completed a non-verbal reasoning task with analogous stimuli. They selected objects after observing the experimenter make a choice and inferring the basis for selection. In the communication task, the children produced fewer size than colour descriptions, particularly when the size targets differed in colour. They also over-specified colour features more often than size. They did not show a similar challenge identifying size relationships in the non-verbal task. The results support the conclusion that target attributes have a systematic influence on children's referential performance. Potential mechanisms for these effects, and directions for future research are discussed.

Evaluation of an audiovisual-FM system: speechreading performance as a function of distance.

A research program was undertaken to evaluate the efficacy of an audiovisual-FM system as a speechreading aid. The present study investigated the effects of the distance between the talker and the speechreader on a visual-speech perception task. Sentences were recorded simultaneously with a conventional Hi8 mm video camera, and with the microcamera of an audiovisual-FM system. The recordings were obtained from two talkers at three different distances: 1.83 m, 3.66 m, and 7.32 m. Sixteen subjects completed a visual-keyword recognition task. The main results of the investigation were as follows: For the recordings obtained with the conventional video camera, there was a significant decrease in speechreading performance as the distance between the talker and the camera increased. For the recordings obtained with the microcamera of the audiovisual-FM system, there were no differences in speechreading as a function of the test distances. The findings of the investigation confirm that in a classroom setting the use of an audiovisual-FM system may constitute an effective way of overcoming the deleterious effects of distance on speechreading performance.

Predicting tense: finite verb morphology and subject pronouns in the speech of typically-developing children and children with specific language impairment.

According to the AGREEMENT/TENSE (Agr/Tns) OMISSION MODEL, children's failure to produce finite verb morphemes represents the selection of an optional infinitive form, in which tense and/or agreement is not specified. When agreement is specified, nominative case is licensed. Following the assumptions of this model, a child's utterance such as She run reflects a failure to specify tense only, given that the subject pronoun shows nominative case. We tested this assumption in two studies through the analysis of spontaneous speech samples from young typically-developing (TD) children and children with specific language impairment (SLI). In Study 1, 15 children were included (TD aged 2;1-3;11, SLI aged 4;0-6;2); in Study 2, 33 children were included (TD aged 2;5-3;11, SLI aged 3;6-6;9). We determined whether there was a relationship between the children's use of past tense -ed and their use of third person singular -s and copula is when nominative case was also used. Because nominative case was used, any failures to produce third person singular -s and copula is should be attributable to tense and not agreement. Such use should therefore be related to the children's use of -ed which presumably hinges on tense only. However, a relationship was not found in the speech of either group of children. This was true both for the children in each group who were consistent in using nominative case pronouns and for those who were not. Possible reasons for these findings are discussed.

The use of grammatical morphemes reflecting aspect and modality by children with specific language impairment.

Children with specific language impairment (SLI) have well-documented problems in the use of tense-related grammatical morphemes. However, in English, tense often overlaps with aspect and modality. In this study, 15 children with SLI (mean age 5;2) and two groups of 15 typically developing children (mean ages 3;6 and 5;3) were compared in terms of their use of previously studied morphemes in contexts that more clearly assessed the role of aspect. The children's use of less frequently studied morphemes tied to modality or tense was also examined. The children with SLI were found to use -ing to mark progressive aspect in past as well as present contexts, even though they were relatively poor in using the tense morphemes (auxiliary was, were) that should accompany the progressive inflection. These children were inconsistent in their use of third person singular -s to describe habitual actions that were not occurring during the time of their utterance. However, the pattern of the children's use suggested that the source of the problem was the formal tense feature of the inflection, not the habitual action context. The children's use of modal can was comparable to that of the typically developing children, raising the possibility that the modality function of possibility had been learned without necessarily acquiring the tense feature of this morpheme. These children's proficiency with can suggests that their bare verb stem productions should probably not be re-interpreted as cases of missing modals. Together these findings suggest that the more serious tense-related problems seen in English-speaking children with SLI co-occur with a less impaired ability to express temporal relations through aspect and modality.

Surface forms and grammatical functions: past tense and passive participle use by children with specific language impairment.

Children with specific language impairment (SLI) use past tense -ed in fewer obligatory contexts than younger normally developing children matched for mean length of utterance (MLU). In this study, the use of passive participle -ed (e.g., kissed in The frog got kissed by the kitty) as well as past tense -ed was examined in children with SLI, normally developing children matched for age (ND-A), and normally developing children matched for MLU (ND-MLU). The children with SLI used both past tense -ed and passive participle -ed in fewer obligatory contexts than bath the ND-A and the ND-MLU children. Only the children with SLI had greater difficulty with past tense -ed than with passive participle -ed. The pattern of findings indicates that the surface properties of -ed cannot adequately account for the past tense -ed difficulty shown by the children with SLI. However, the fact that the children with SLI were less consistant than the ND-MLU children in using passive participle -ed suggests that either the surface properties of -ed are responsible for a portion of the difficulty or these children have a separate, non-tense-related deficit in the area of verb morphology.

Production operations and the use of nonfinite verbs by children with specific language impairment.

Recent evidence from structural priming studies suggests that children with specific language impairment (SLI) are more likely to produce verb morphemes such as auxiliary is when their previous sentence contained an auxiliary than when it did not. The same paradigm was employed in the present study to determine whether failures to include auxiliary is might be due to prior use of nonfinite sentences (e.g., The mouse eating the cheese). Preschoolers with SLI and a group of younger normally developing children were more likely to produce auxiliary is to describe target pictures when the preceding sentence contained auxiliary are than when it contained past tense. Use of is in the target sentence was least likely when the preceding sentence was nonfinite. The implications of these findings for current accounts of SLI and current models of sentence production are discussed.