Clinical utility of shared book reading on YouTube: An analysis of metadata, evidence-based content, understandability, and actionability.

PURPOSE: Digital content may increase parental access to training as well as the diversity of the training programs. YouTube videos may provide a platform from which professionals may adopt content for such programs. This study provides data regarding the clinical utility of YouTube videos about shared book reading (SBR) found on the United States (USA) and India channels. METHOD: A cross-sectional analysis of videos about SBR was conducted to examine metadata, evidence-based content, understandability, and actionability. Descriptive statistics were used to analyse metadata and content. Health literacy concepts of understandability and actionability were measured, and descriptive statistics are reported. RESULT: Of 800 videos identified, 10 included information related to storybook selection, dialogic reading, extra-textual strategies, and print-referencing strategies. These met adequate levels of understandability and actionability. CONCLUSION: Results provide some direction and recommendations for parent-training programs in the USA and India. The study highlights the use of YouTube videos and suggests its utility as a supplement source within parent-training programs.

A Cross-Sectional Descriptive Analysis of Speech, Hearing, and Feeding in YouTube Videos: A Brief Communication.

OBJECTIVE: Healthcare information on YouTube is often inaccurate or insufficient. However, parents turn to social media for answers about their children's health conditions. Understanding the nature of content in specified scope of practice areas can help professionals clarify misinformation or utilize quality YouTube content in clinical context. This research examined: (1) meta-data and upload source; (2) understandability and actionability; and (3) content quality and clinical utility of YouTube videos related to speech, hearing, and feeding with children with cleft lip and palate (CLP). DESIGN: A cross-sectional design was used. MAIN OUTCOME MEASURE(S): Videos related to speech, hearing, and feeding with children with CLP were obtained. Meta-data and upload source were identified. The Patient Education Material Assessment Tool-AudioVisual (PEMAT-AV) was used to assess understandability and actionability. The DISCERN instrument was used to evaluate content quality. Responses to open-ended questions were used to evaluate clinical utility. RESULTS: Of 652 videos reviewed for potential inclusion, only 33 met the inclusion criteria. Of those, only 17 met adequate levels of both understandability and actionability. Results of DISCERN indicated that the videos were of fair quality. Analysis of clinical utility indicated that none of the videos should be used as stand-alone parent education materials. CONCLUSIONS: Videos pertaining to speech, hearing and feeding issues are not viewed as frequently as videos addressing other areas of CLP. Our findings are consistent with previous reports that the videos related to CLP may be limited in their clinical utility. Professionals are needed to interpret the offerings and guide families to appropriate videos.

Speech-Language Pathologist's Role in Understanding and Promoting Self-Advocacy in Autistic Adults.

PURPOSE: This tutorial introduces speech-language pathologists (SLPs) to strategies that promote and support self-advocacy among autistic college students. The discussion for this tutorial is grounded within the framework of the social model of disability and the need for addressing environmental barriers to communication and self-advocacy. METHOD: We provide a self-advocacy framework to guide SLPs in developing programs for autistic adults. We describe factors that impact self-advocacy in autistic college students and the role of university-based SLPs and speech-language pathology graduate students in program implementation. Scenarios and examples are included to aid SLPs in implementing the recommendations. CONCLUSIONS: Self-advocacy is a predictor of retention, adaptation, and graduation of autistic postsecondary students. Prior research on autistic self-advocacy is minimal, and guidance for SLPs on promoting and supporting self-advocacy of their autistic clients is limited. SLPs play a very important role as they can increase understanding and appreciation for autistic social communication differences among nonautistic peers and professors and address autistic stigma through meaningful engagement of autistic individuals in planning and program development.

Development and Functionality of an Internet-Based, Self-Managed Parent Training Program.

Purpose This research note evaluated a self-managed, Internet intervention (i.e., Success With Stories) designed to facilitate parental reading practices and beliefs. Method Twelve reviewers were composed of parents of young children, speech-language pathologists, and experts in self-managed, Internet intervention. Satisfaction of usability, content, presentation, suitability, and exercises of Success With Stories was examined using an intervention satisfaction rating. Value and usefulness of content was evaluated via a survey. Results Reviewers found content to be valuable and useful for facilitating parental reading practices and beliefs. Results indicated high satisfaction across all reviewers. Conclusion Results point toward strengths and limitations of the protocol and future directions.

A Comparison of Intervention Intensity and Service Delivery Models With School-Age Children With Speech Sound Disorders in a School Setting.

Purpose This study examined intervention intensity and service delivery with school-age children with mild or mild-moderate speech sound disorders. The commonly used business-as-usual (BAU) service delivery model and a shorter, more frequent, individual model (experimental [EXP]) were compared. Method A between-subjects group design was selected. In BAU, 11 children received group sessions, 2 times per week, 30 min per session for 6 weeks. In EXP, 11 children received individual session, 3 times per week, 5 min per session for 6 weeks. Group differences on measures of dose (i.e., therapeutic input and production trials) and cumulative treatment intensity were examined. The extent to which children, across both conditions, demonstrated gains in speech sound accuracy and the extent to which gains differed between BAU and EXP were examined. Results There was a significant group difference on dose. Children in BAU received more therapeutic input and production trials than children in EXP. Cumulative treatment intensity was not statistically different between groups when dose was calculated as therapeutic input or production trials. Results from both conditions indicated statistically significant differences on measures of speech sound accuracy with large effect sizes. No group differences on gains were noted. Conclusions Dose calculated as therapeutic input and production trials plays an important role in understanding the impact of cumulative intervention intensity. Children with mild or mild-moderate speech sound disorders may benefit more from a shorter, frequent, individual service delivery model than a BAU model.

"Providing a perspective that's a little bit different": Academic and professional experiences of male speech-language pathologists.

PURPOSE: A significant gender imbalance exists in the profession of speech-language pathology and the perspectives of male speech-language pathologists are underrepresented in the professional literature. This study explored the role of gender as a factor related to the academic and professional experiences of male speech-language pathologists working in the United States. METHOD: Phenomenology was used to understand factors influencing the lived experiences of males in the profession. In-depth semi-structured interviews were collected from fifteen male speech-language pathologists and subjected to inductive thematic analysis. RESULT: Four superordinate and thirteen subordinate themes emerged from the data. Findings suggest that males experience challenges working in a female-dominated profession. That said, males highlighted their progression towards inclusion in the profession and overall perceived their academic and professional life as positive and rewarding. Participants valued the distinctive quality of being male in a female-dominated profession and described a sense of empowerment by virtue of being male. CONCLUSION: A gender disparity remains present in the field of speech-language pathology, which limits the ability to best serve a diverse population and creates health disparities. While participants reported many challenges working in a female-dominated profession, these obstacles appeared to motivate rather than hinder work-related performance and overall job satisfaction. The themes presented here help to develop a deeper understanding of the perspectives of males in the field and the specific factors that contribute to their experiences. Additionally, these data can inform future strategies for recruitment and retention of males in the profession.

Applied Behavior Analysis as Treatment for Autism Spectrum Disorders: Topic Modeling and Linguistic Analysis of Reddit Posts.

Background: It is critical for professionals to understand the discourse landscape within various online and social media outlets in order to support families of children with autism in treatment decision-making. This need is heightened when considering treatments that have garnered excitement and controversy, such as applied behavioral analysis (ABA) therapy. Method: The specific aims of this study were to identify the main themes in Reddit posts about ABA-based interventions for autism using topic modeling, to examine the linguistic aspects of Reddit conversations using the Linguistic Inquiry and Word Count (LIWC) analysis, and to examine the relationship between linguistic aspects and user category (i.e., pro- vs. anti-ABA vs. undecided, parent vs. professional vs. an individual with autism). Results: The topic modeling resulted in 11 themes that ranged across various elements, such as autism as a condition and its management, stakeholders, and consequences of autism and the support needed. The posts of individuals were focused on personal experiences and opinions as opposed to clinical and research information sharing. Linguistic analysis indicated that the posts reveal an intimate stance rather than an empirical stance. Conclusions: Results provide insight into perspectives of ABA. This type of research may help in developing and distributing appropriate and evidence-based information.

Quality and readability of internet information about stuttering.

PURPOSE: We examined the quality and readability of English-language Internet information about stuttering and evaluated the results considering recommendations by experts in health literacy. METHOD: A search of Internet websites containing information about stuttering was conducted. Three key words (i.e., stuttering, stammering, speech disfluency) were entered into five country-specific versions of the most commonly used Internet search engine. A total of 79 websites were assessed. Their origin (commercial, non-profit, government, personal or university), quality [Health On the Net (HON) certification and DISCERN scores], and readability [Flesch Reading Ease (FRE) score, Flesch-Kincaid Grade Level Formula (F-KGL), and Simple Measure of Gobbledygook (SMOG)] were assessed. RESULTS: Of the 79 websites, 38 % were of commercial, 42 % were of nonprofit organization, 15 % were of government and 5% were of university origins, respectively. Only 13 % had obtained HON certification and the mean DISCERN scores was 3.10 in a 5-point scale. The mean reading grade levels were at 13th and 14th grade and 100 % of the websites exceeded the recommended 5th to 6th reading grade level for health information. CONCLUSIONS: The quality of Internet-based health information about the treatment of stuttering is generally adequate, but actual usability of the sites examined in this study may be limited due to poor readability levels. This is problematic in persons with poor literacy skills. Since the Internet can be readily accessed as a valuable consumer information resource, speech-language pathologists and other healthcare professionals have an opportunity to direct consumers to websites that provide readable information of good quality.

A Content Analysis of YouTube Videos Related to Hearing Aids.

BACKGROUND: Increasingly, people access Internet-based health information about various chronic conditions including hearing loss and hearing aids. YouTube is one media source that has gained much popularity in recent years. PURPOSE: The current study examines the source, content, understandability, and actionability of YouTube videos related to hearing aids. RESEARCH DESIGN: Cross-sectional design by analyzing the videos at single point in time. STUDY SAMPLE: One hundred most frequently viewed videos in YouTube. INTERVENTION: Not applicable. DATA COLLECTION AND ANALYSIS: The 100 most-viewed English language videos targeting individuals seeking information regarding hearing aids were identified and manually coded. Data collection included general information about the video (e.g., source, title, authorship, date of upload, duration of video), popularity-driven measures (e.g., number of views, likes, dislikes), and the video source (consumer, professional, or media). The video content was analyzed to examine what pertinent information they contained in relation to a predetermined fact sheet. Understandability and actionability of the videos were examined using the Patient Education Material Assessment Tool for Audiovisual Materials. RESULTS: Of the 100 most-viewed videos, 11 were consumer-based, 80 were created by professionals, and the remaining 9 were media-based. General information about hearing aids, hearing aid types, and handling and maintenance of hearing aids were the most frequently discussed content categories with over 50% of all videos commenting on these areas. Differences were noted between source types in several content categories. The overall understandability scores for videos from all sources were 74%, which was considered adequate; however, the actionability scores for all the videos were 68%, which is considered inadequate. CONCLUSION: YouTube videos about hearing aids focused on a range of issues and some differences were found between source types. The poor actionability of these videos may result in incongruous consumer actions. Content and quality of the information in hearing aid YouTube videos needs to be improved with input from professionals.

Use of Videos and Digital Media in Parent-implemented Interventions for Parents of Children with Primary Speech Sound And/or Language Disorders: A Scoping Review.

No review to date has focused on evaluating the use of videos and digital media in parent-implemented interventions for parents of children with primary language or speech sound disorder (LD/SSD). Research objectives guiding this scoping review included an evaluation of (a) use of videos and/or other digital media in parent-implemented interventions; (b) use of videos and/or other digital media in asynchronous content; (c) the role of the parent as learner; and (d) the program impact on parents and children. This review followed a five-stage framework: (a) identify research questions; (b) identify relevant studies; (c) select studies; (d) chart the data; and (e) collate, summarize and report the results. Ten studies were included. No program included parents of children with speech disorders. One fully asynchronous program was identified, though many programs included videos concurrent with direct instruction. No study described the parent as learner and only four studies examined parent satisfaction and perceptions. These four studies directly measured specific parent behavior and results indicated that the programs had a positive impact on parents' interactions. Nine of the ten studies included child outcomes. This low volume of studies suggests limited work in this area. The review describes research gaps and future directions.

The Utility of Cinematherapy for Stuttering Intervention: An Exploratory Study.

This preliminary study explored the feasibility and benefits of using cinematherapy with adults who stutter to address affective and cognitive reactions to stuttering and their impact on the persons' life. A mixed methods research design was used to explore the impact of cinematherapy. Four clients completed a 4-week structured cinematherapy program. All clients completed two questionnaires: Unhelpful Thoughts and Beliefs about Stuttering and Overall Experience of the Speaker's Experience of Stuttering, before starting and after completing the program. At the end of the program, clients also completed a semistructured interview. The semistructured interviews provide insight on clients' perceptions of cinematherapy, and questionnaires provided quantitative insights on the clients' perceptions of change. Qualitative data analysis indicated that clients reported five themes related to perceptions of cinematherapy: Promoted Vulnerability; Nurtured Empowerment; Stimulated Self-Reflection; Incited Feelings of Belonging; and Diminished Self-Stigma. Overall, clients reported a clinically significant decrease in scores on both questionnaires after completion of the 4-week cinematherapy program. Results indicate that cinematherapy was well received and had a positive impact on cognitive and affective aspects of stuttering in the four adult clients. These results provide preliminary support for larger scale clinical trials of cinematherapy as an adjuvant to traditional stuttering therapy.

Portrayal of Hearing Loss in YouTube Videos: An Exploratory Cross-Sectional Analysis.

Objective The objective of the current study was to examine the source, content, understandability, and actionability of hearing loss information on YouTube videos. Method The study used a cross-sectional design. One hundred of the most frequently viewed YouTube videos were identified, and various data were manually coded (i.e., video source, video content, popularity measures such as number of views, likes, and dislikes). In addition, the understandability and actionability of each video were evaluated using the Patient Education Materials Assessment Tool for Audiovisual Materials rating scale. Results Of the 100 most viewed videos, 16 were created by consumers, 62 were professional created, and 22 were media based. Symptoms, causes, and treatment or management of hearing loss were the most frequently discussed content categories, with over 60% of all videos commenting on these areas. The overall understandability and actionability scores for the 100 videos included were 77% and 31%, respectively, indicating adequate understandability and poor actionability. Conclusions The YouTube videos on hearing loss focus on a range of issues. The poor actionability of these videos was a concern, as these videos may not lead to appropriate consumer actions in addressing their hearing loss. Efforts are needed to improve the quality and content of these videos to promote appropriate behavior change.

Twitter usage about autism spectrum disorder.

Stakeholders within autism spectrum disorder communities use Twitter for specific purposes. The goal of this study was to characterize patterns and themes of tweet content and sentiment and intercommunications between users sending and retweeting content to their respective user networks. The study used cross-sectional analysis of data generated from Twitter. Twitter content, sentiment, users, and community networks were examined from a sample of tweets with the highest Twitter reach and the lowest Twitter reach. Results indicate that Twitter content from both samples was primarily related to empowerment and support. Differences between the number of tweets originating from an individual in the lowest reach sample (i.e. 41%) as compared to the individuals in the highest reach sample (i.e. 18%) were noted. The number of users belonging to an advocacy subcommunity was substantially larger than a clinical and research subcommunity. Results provide insight into the presuppositions of individuals with autism spectrum disorder, their families and significant others, and other stakeholders.

A cross-sectional study of the portrayal of childhood speech and language disorders in YouTube videos.

PURPOSE: This study examined meta-data, source, type of informational content, understandability, and actionability of YouTube content related to speech and/or language disorders. METHOD: The 100 most widely viewed videos related to children with speech and/or language disorders were obtained. Meta-data and sources of each upload were identified. Type of informational content within the videos was analyzed. The Patient Education Material Assessment Tool for Audiovisual Materials was used to assess understandability and actionability. RESULTS: A significant difference between video source groups was found for length of video, thumbs-up, and thumbs-down, but not for number of views. The YouTube videos related to speech and/or language disorders covered a range of issues, although a majority of the content focused on signs/symptoms and treatment. Videos had close-to-adequate understandability (i.e. 68%), although poor actionability scores (i.e. 32%) were noted. Videos uploaded by professionals were superior to other upload sources in understandability, but no difference was noted between video source for actionability. CONCLUSIONS: Study insights about meta-data, source, type of informational content, understandability, and actionability of YouTube videos may help professionals understand the nature of online content related to speech and/or language disorders. Study implications and recommendations for further research are discussed.

Quality, Readability, and Suitability of Hearing Health-Related Materials: A Descriptive Review.

Objectives The objective of this descriptive review was to determine the quality, readability, and suitability of ear and hearing health information and materials for patients and their significant others. Method A literature search was conducted between August 2018 and April 2019 in the databases CINAHL Complete, MEDLINE, and PsychInfo. Inclusion and exclusion criteria were used to shortlist studies. Data regarding quality, suitability, and readability were extracted from the included studies. Data were assessed qualitatively. Results There were 34 studies included in this review. Of those, eight examined quality, 33 assessed readability, and four investigated the suitability of materials. The range of materials assessed included diagnostic reports, patient education materials (PEMs), patient-reported outcome measures, and websites. Quality elements were examined in studies focusing on website information. Findings indicated that most websites were of poor quality. Suitability was examined in studies focusing on PEMs such as hearing aid user guides. Findings indicated that most of the existing materials were not suitable for the intended populations. The reading grade level of information across all four categories was found to be higher than the recommended fifth or sixth reading grade level for health-related materials. Revisions of some diagnostic reports and PEMs showed that improvements are possible. Conclusions This review suggests that ear- and hearing-related materials generally have lower quality and suitability with higher readability (more difficult to read). Development of materials that are suitable, of high quality, and at the appropriate readability levels is required to improve accessibility of ear- and hearing-related materials.

Twitter Usage Using Common Reference to Tinnitus.

Objective The objective of the study was to examine specific patterns of Twitter usage using common reference to tinnitus. Method The study used cross-sectional analysis of data generated from Twitter data. Twitter content, language, reach, users, accounts, temporal trends, and social networks were examined. Results Around 70,000 tweets were identified and analyzed from May to October 2018. Of the 100 most active Twitter accounts, organizations owned 52%, individuals owned 44%, and 4% of the accounts were unknown. Commercial/for-profit and nonprofit organizations were the most common organization account owners (i.e., 26% and 16%, respectively). Seven unique tweets were identified with a reach of over 400 Twitter users. The greatest reach exceeded 2,000 users. Temporal analysis identified retweet outliers (> 200 retweets per hour) that corresponded to a widely publicized event involving the response of a Twitter user to another user's joke. Content analysis indicated that Twitter is a platform that primarily functions to advocate, share personal experiences, or share information about management of tinnitus rather than to provide social support and build relationships. Conclusions Twitter accounts owned by organizations outnumbered individual accounts, and commercial/for-profit user accounts were the most frequently active organization account type. Analyses of social media use can be helpful in discovering issues of interest to the tinnitus community as well as determining which users and organizations are dominating social network conversations.

Media Use by Older Adults With Hearing Loss: An Exploratory Survey.

Objectives There has been a substantial increase in people with health conditions seeking health-related information online. The aim of this study was to examine the media usage by older adults with hearing loss. Method The study used a cross-sectional survey design. A total of 556 older adults with hearing loss (Hearing Tracker website users) completed the survey that was focused on (a) demographic information, (b) general electronic media usage, (c) sources of hearing health information, and (d) social media use for hearing health information. Data were analyzed using descriptive statistics and chi-square tests. Results When seeking hearing health care information, the majority of the participants turned to the Internet (54%) followed by health professionals (34%) as the first response to their symptoms. Both sources were also rated as the easiest means of obtaining hearing health information. The information from health care providers was rated as more reliable and important for decision making than that from the Internet. Facebook and YouTube were the most frequently used social media platforms with over 40% of the respondents using them "most of the time" or "sometimes." All the social media platforms were rated less favorably than other sources for ease of finding information, reliability, and importance in decision making. Conclusion Older adults with hearing loss use various forms of electronic media for seeking hearing health information. They place the most trust on the information obtained from hearing health care professionals. These professionals need to be aware of the quality of information available on the Internet and social media sources in order to direct patients to credible sources. Supplemental Material https://doi.org/10.23641/asha.12170397.

A cross-sectional descriptive analysis of portrayal of autism spectrum disorders in YouTube videos: A short report.

Professionals have expressed concerns about the quality of autism-related information available from Internet-based sources. The purpose of this study was to examine the source, content, usability, and actionability of autism spectrum disorder-related information contained in 100 different videos directed to families of children with autism spectrum disorder uploaded to YouTube. Upload sources were identified, and video content was coded. Understandability and actionability of the videos were examined using Patient Education Materials Assessment Tool for Audiovisual Materials. The collective number of views of the videos was almost 100 million. The length of videos was 691.17 min (i.e. 11.5 h) with the shortest video being 30 s and the longest video being 37.36 min. The YouTube videos related to autism spectrum disorder covered a range of issues, although much of the content was focused on signs and symptoms. No difference in content reporting was noted based on sources for most categories, although differences were noted in some categories (e.g. professionals mentioned diagnosis and resources more frequently). Poor understandability and actionability scores (i.e. below 70%) were reported for all videos regardless of video source. However, the videos generated by the professionals were superior in terms of understandability. Study implications and recommendations for further research are discussed.

Suitability of English Language Internet-Based Information for Voice Disorders.

PURPOSE: The study was aimed at assessing the suitability of English-language Internet health information related to vocal hygiene, vocal health, and prevention of voice disorders. We also examined the relation between suitability, readability, and quality of Internet health information. METHOD: Suitability of 77 websites from Dueppen et al9 was assessed using the Suitability Assessment of Materials tool. Information about readability and quality of the websites were extracted from Dueppen et al.9 RESULTS: The overall converted suitability percent score of all 77 websites was 66.4%, which represents "adequate" suitability. Individual websites were rated as superior (ie, 44.2%) adequate (ie, 51.9%), and not suitable (ie, 3.9%). No relation was found between website origin and the suitability ratings. The inter-rater reliability of the Suitability Assessment of Materials ratings for overall scale was found to be good. The suitability of websites had a moderate correlation with readability measures, but no significant correlation was observed between the suitability and quality of websites. CONCLUSIONS: The study results suggest that overall suitability of websites on vocal hygiene are adequate. However, many websites may require improvements in some elements (eg, literacy demand, graphics, and learning stimulation). Readability, quality, and suitability are important components in the accessibility of health information for people with different health conditions. Hence, improvements in these elements are expected to improve the understanding and actionability of people with voice issues.

Quality and Readability of English-Language Internet Information for Voice Disorders.

PURPOSE: The purpose of this study is to evaluate the readability and quality of English-language Internet information related to vocal hygiene, vocal health, and prevention of voice disorders. This study extends recent work because it evaluates readability, content quality, and website origin across broader search criteria than previous studies evaluating online voice material. METHOD: Eighty-five websites were aggregated using five different country-specific search engines. Websites were then analyzed using quality and readability assessments. The entire web page was evaluated; however, no information or links beyond the first page was reviewed. Statistical calculations were employed to examine website ratings, differences between website origin and quality and readability scores, and correlations between readability instruments. RESULT: Websites exhibited acceptable quality as measured by the DISCERN. However, only one website obtained the Health On the Net certification. Significant differences in quality were found among website origin, with government websites receiving higher quality ratings. Approximate educational levels required to comprehend information on the websites ranged from 8 to 9 years of education. Significant differences were found between website origin and readability measures with higher levels of education required to understand information on websites of nonprofit organizations. CONCLUSION: Current vocal hygiene, vocal health, and prevention of voice disorders websites were found to exhibit acceptable levels of quality and readability. However, highly rated Internet information related to voice care should be made more accessible to voice clients through Health On the Net certification.