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1.
Artigo em Inglês | MEDLINE | ID: mdl-32383829

RESUMO

BACKGROUND: Collaboration between parents and speech and language therapists (SLTs) is seen as a key element in family-centred models. Collaboration can have positive impacts on parental and children's outcomes. However, collaborative practice has not been well described and researched in speech and language therapy for children and may not be easy to achieve. It is important that we gain a deeper understanding of collaborative practice with parents, how it can be achieved and how it can impact on outcomes. This understanding could support practitioners in daily practice with regard to achieving collaborative practice with parents in different contexts. AIMS: To set a research agenda on collaborative practice between parents and SLTs in order to generate evidence regarding what works, how, for whom, in what circumstances and to what extent. METHODS & PROCEDURES: A realist evaluation approach was used to make explicit what collaborative practice with parents entails. The steps suggested by the RAMESES II project were used to draft a preliminary programme theory about collaborative practice between parents and SLTs. This process generates explicit hypotheses which form a potential research agenda. DISCUSSION & CONCLUSIONS: A preliminary programme theory of collaborative practice with parents was drafted using a realist approach. Potential contextual factors (C), mechanisms (M) and outcomes (O) were presented which could be configured into causal mechanisms to help explain what works for whom in what circumstances. CMO configurations were drafted, based on the relevant literature, which serve as exemplars to illustrate how this methodology could be used. In order to debate, test and expand our hypothesized programme theory for collaborative practice with parents, further testing against a broader literature is required alongside research to explore the functionality of the configurations across contexts. This paper highlights the importance of further research on collaborative practice with parents and the potential value of realist evaluation methodology. What this paper adds Current policy in education, health and social care advocates for family-centred care and collaborative practice with parents. Thereby, collaborative practice is the preferred practice for SLTs and parents. In this paper, we explore collaborative practice and use a realist evaluation approach to achieve the aim of setting a research agenda in this area. Researchers use realist evaluation, a methodology originally developed by Pawson and Tilley in the 1990s, to explore the causal link between interventions and outcomes, summarized as what works, how, for whom, in what circumstances and to what extent. Realist evaluation provides a framework to explore configurations between contexts (C), mechanisms (M) and outcomes (O). We used this methodology to take a first step at making explicit what collaborative practice is and how it might be achieved in different contexts. We did this by drafting a preliminary programme theory about collaborative practice, where we made explicit what context factors and mechanisms might influence outcomes in collaborative practice between parents and SLTs. Based on this programme theory, we argue for the need to develop a research agenda on collaborative practice with parents of children with speech, language and communication needs. The steps between a programme theory and a research agenda could entail exploring each CMO, or step in the programme theory, and evaluating it against the existing literature-both within and beyond speech and language therapy-to see how far it stands up. In this way, gaps could be identified that could be converted into research questions that would stimulate debate about a research agenda on collaborative practice. Understanding how collaborative practice can be achieved in different contexts could support SLTs to use mechanisms to optimise collaborative practice intentionally and tailor interventions to the specific needs of families, thereby enhancing collaborative practice between parents and SLTs.

2.
Clin Linguist Phon ; 34(4): 293-311, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31291748

RESUMO

The number of children speaking more than one language as well as the number of languages spoken in Ireland has increased significantly posing a problem for timely identification of children with language disorder. The current study aims to profile performance of monolingual and multilingual children on language processing tasks: non-word repetition (NWR) and sentence repetition (SR). We used: (1) Crosslinguistic (CL) and English Language-Specific (LS) NWR and (2) SR in English, Polish and Russian. Children's socioeconomic status, language emergence, the age of exposure (AoE) to English and the percentage of English spoken at home were recorded. The study included 88 children age 5-8 attending a school in a disadvantaged area.CL and LS NWR yielded similar distribution of scores for monolinguals and multilinguals. The tasks identified small number of children who performed significantly lower than the mean while there were no significant differences between the groups. In English SR, monolinguals significantly outperformed multilinguals. Comparison of SR in English and Polish/Russian indicated that some children showed balanced performance in both of their languages while others showed marked differences performing better in either Polish/Russian or English depending on their AoE to English and percentage of English spoken at home.The pilot study suggests that CL-NWR is a promising screening tool for identifying monolingual and multilingual children with language disorder while SR provides more detailed information on children's language performance relative to their language exposure. SR task is recommended to be used only if comparable tasks are available in all of children's languages.

3.
J Commun Disord ; 82: 105922, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31425855

RESUMO

BACKGROUND: The relationship between parental input and child language development has had a complex history. It has become clear that indirect parent training for the parents of children with delayed language development is an important feature of interventions offered by speech and language therapists in the anglophone countries. Yet we know less about how this type of approach is realised in other countries. METHODS: In this paper we report the results of a survey of practice undertaken as part of the work of COST Action IS1406, a European Union (EU) funded research network. The focus of this paper is specifically on parent-related questions and responses referring to children under the age of twelve. The survey was devised by members of the Action and circulated electronically during the summer of 2017. In all, 4024 practitioners responded from 60 countries, the majority of whom came from EU member countries. FINDINGS: Respondents to the survey indicated that indirect therapy is commonly carried out via the parent in the early years and via teachers later. A range of professional groups, in addition to speech and language therapists, is likely to adopt this approach; including teachers, pedagogues and psychologists. A variety of interventions is reported, some of which have a reasonable evidence-base underpinning them. It is interesting to see the widespread involvement of fathers and other family members in interventions. Finally, the fact that practitioner characteristics (age, experience, location of practice etc.) are not related to the use of indirect techniques points to the universal recognition of the value of these approaches. CONCLUSIONS: Despite the very different traditions in the practice of intervention across countries, there is clearly a widespread recognition of the importance of indirect approaches to intervention and specifically those focusing on parents. The mixture of family members being involved in interventions is a very promising indication of the role sharing commonly associated with the contemporary family. Yet the number of specific intervention approaches identified is relatively small given the number of respondents. There is a need for a better understanding of what exactly practitioners are doing when they involve parents in intervention or carry out parent-child interaction interventions and how well these interventions work in routine practice. This also has implications for the application of evidence-based practice and the precise nature of the interventions concerned (advice to parents, video interaction training etc.).

4.
J Commun Disord ; 72: 16-25, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29462740

RESUMO

There are policy and theoretical drivers for listening directly to children's perspectives. These perspectives can provide insights to children's experiences of their daily lives and ways in which they construct their multiple identities. Qualitative methodology is a useful research paradigm with regard to exploring children's experiences. However, listening to the perspectives of children with speech and language disorders is a relatively new field of research. Therefore, it is important that researchers share their experiences of using methods and reflect on the strengths and limitations of these methods. The authors have used narrative inquiry with children with speech and language disorders to explore ways in which these children make sense of their experiences and construct their identities. In this paper, the authors reflect on methodological considerations when using narrative inquiry with children with speech and language disorders. They critically discuss three methodological considerations: narrative inquiry as a methodological choice, methods for data generation, limitations, and rigour.


Assuntos
Narração , Distúrbios da Fala/psicologia , Voz/fisiologia , Percepção Auditiva , Criança , Humanos , Pesquisa Qualitativa
5.
J Speech Lang Hear Res ; 61(2): 324-344, 2018 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-29374284

RESUMO

Purpose: Children with speech and language disorders are at risk in relation to psychological and social well-being. The aim of this study was to understand the experiences of these children from their own perspectives focusing on risks to their well-being and protective indicators that may promote resilience. Method: Eleven 9- to 12-year-old children (4 boys and 7 girls) were recruited using purposeful sampling. One participant presented with a speech sound disorder, 1 presented with both a speech and language disorder, and 9 with language disorders. All were receiving additional educational supports. Narrative inquiry, a qualitative design, was employed. Data were generated in home and school settings using multiple semi-structured interviews with each child over a 6-month period. A total of 59 interviews were conducted. The data were analyzed to identify themes in relation to potential risk factors to well-being and protective strategies. Results: Potential risk factors in relation to well-being were communication impairment and disability, difficulties with relationships, and concern about academic achievement. Potential protective strategies were hope, agency, and positive relationships. Conclusion: This study highlights the importance of listening to children's narratives so that those at risk in relation to well-being can be identified. Conceptualization of well-being and resilience within an ecological framework may enable identification of protective strategies at both individual and environmental levels that can be strengthened to mitigate negative experiences.


Assuntos
Transtornos da Linguagem/psicologia , Resiliência Psicológica , Distúrbios da Fala/psicologia , Transtorno Fonológico/psicologia , Desempenho Acadêmico/psicologia , Criança , Feminino , Humanos , Relações Interpessoais , Entrevistas como Assunto , Masculino , Fatores de Proteção , Pesquisa Qualitativa
6.
Int J Speech Lang Pathol ; 20(1): 16-20, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29192799

RESUMO

According to Article 19 of the Universal Declaration on Human Rights "Everyone has the right to freedom of opinion and expression; this right includes freedom to hold opinions without interference and to seek, receive and impart information and ideas through any media and regardless of frontiers." The purpose of this paper is to elucidate communication as a human right in the life of a young man called Declan who has Down syndrome. This commentary paper is co-written by Declan, his sister who is a speech-language pathologist (SLP) with an advocacy role, his SLP, and academics. Declan discusses, in his own words, what makes communication hard, what helps communication, his experiences of speech-language pathology, and what he knows about human rights. He also discusses his passion for politics, his right to be an active citizen and participate in the political process. This paper also focuses on the role of speech-language pathology in supporting and partnering with people with communication disabilities to have their voices heard and exercise their human rights.


Assuntos
Transtornos da Comunicação , Direitos Humanos , Patologia da Fala e Linguagem , Comunicação , Transtornos da Comunicação/etiologia , Síndrome de Down/complicações , Humanos , Patologia da Fala e Linguagem/métodos
7.
Int J Speech Lang Pathol ; 20(1): 59-62, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29192805

RESUMO

Although Article 19 of the Universal Declaration of Human Rights states that "everyone has a right to freedom of opinion and expression", for people with communication disability this may not be a reality. This commentary shares a practical example of how people with communication disabilities together with speech-language pathology (SLP) students, academics and clinical staff co-designed and co-implemented a Communication Awareness Training Programme for catering staff to enable communication access in coffee shops and restaurants. This is an example of how SLPs can embrace their social responsibility to break down barriers for people with communication disabilities. This commentary shares the reflections of those involved and how they felt empowered because they had learned new skills and made a difference. This commentary highlights the need for co-design and co-delivery of programs to raise awareness of communication disability among catering staff and how the stories of people with communication disabilities served as a catalyst for change. It also highlights the need to SLPs to move intervention to a social and community space.


Assuntos
Transtornos da Comunicação , Direitos Humanos/educação , Restaurantes , Participação Social , Patologia da Fala e Linguagem/métodos , Humanos , Projetos Piloto , Patologia da Fala e Linguagem/educação
8.
Int J Speech Lang Pathol ; 19(5): 503-518, 2017 10.
Artigo em Inglês | MEDLINE | ID: mdl-27631150

RESUMO

PURPOSE: There has been debate about labels in relation to speech and language impairments. However, children's views are missing from this debate, which is risky considering that labels with negative associations may result in stigma. The aim of this study was to explore the range of identities which children with primary speech and language impairments presented in their narratives and to investigate their evaluations of these identities with a view to understanding the values they attach to labels. METHOD: Eleven children aged 9-12 years with primary speech and language impairments were recruited to the study. Fifty nine semi-structured interviews were conducted with the aim of generating storied accounts of everyday experiences. The data were analysed using thematic analysis. Two themes were identified in the data: desired identities and undesired identities. RESULT: The findings suggest that the children were actively involved in identity construction and wanted to be seen in positive ways. They disliked labels assigned by others, which they considered portrayed them in negative ways. CONCLUSION: The debate about labels could be progressed by consulting with children themselves asking for their ideas in relation to labels in specialist education, and speech and language pathology.


Assuntos
Transtornos do Desenvolvimento da Linguagem/psicologia , Identificação Social , Estigma Social , Distúrbios da Fala/psicologia , Criança , Feminino , Humanos , Transtornos do Desenvolvimento da Linguagem/classificação , Masculino , Narração , Distúrbios da Fala/classificação
9.
Int J Lang Commun Disord ; 50(5): 665-75, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25800094

RESUMO

BACKGROUND: Non-attendance and inappropriate referrals affect the effective and efficient running of healthcare services. Non-engagement with speech and language therapy (SLT) services may lead to negative long-term consequences for children in need of SLT intervention. Currently there is a dearth of research on non-attendance and non-engagement with SLT services. AIMS: To identify factors associated with (1) non-attendance and (2) parents' non-engagement with SLT services. METHODS & PROCEDURES: Demographic data were collected from 140 case files of children (aged 5;0-17;11 years) discharged from a public community SLT service (November 2011-October 2013) with no intervention provided. Logistic regression analyses explored relationships between demographic data and (1) non-attendance and (2) non-engagement with the SLT service. OUTCOMES & RESULTS: There was an increased probability of non-attendance during winter (i.e. September-February inclusive; OR = 3.14; p = 0.028) relative to summer, and with each month a child waited for SLT assessment (OR = 1.19; p = 0.066). There was decreased probability of non-attendance with children referred for speech (OR = 0.08; p = 0.011) or language difficulties (OR = 0.15; p = 0.050) relative to dysfluency. The probability of non-engagement with the SLT service increased in each of the following conditions: with each month a child waited for assessment (OR = 1.27; p = 0.004); in urban (OR = 2.40; p = 0.066) relative to rural locations; during winter (OR = 2.65; p = 0.021) relative to summer; and with referrals made by occupational therapists, physiotherapists, psychologists and social workers (OR = 18.65; p = 0.016) relative to doctor referrals. CONCLUSIONS & IMPLICATIONS: Non-attendance is influenced by wait times, season and the reason for referral. Location (urban versus rural), referral source, wait times and season are factors related to non-engagement with SLT services. Targeted policies to improve efficiency and effectiveness of SLT services could be designed around these study findings.


Assuntos
Terapia da Linguagem , Pacientes Desistentes do Tratamento/estatística & dados numéricos , Encaminhamento e Consulta/estatística & dados numéricos , Fonoterapia , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Irlanda , Masculino , Motivação , Estudos Retrospectivos , Estações do Ano , Listas de Espera
10.
Am J Audiol ; 20(1): 9-18, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21474556

RESUMO

PURPOSE: An interdisciplinary research group was established to investigate current and future service provision for children with central auditory processing disorder ([C]APD) in the Republic of Ireland. The aim of Phase 1 was to identify current awareness and knowledge of (C)APD among the relevant professionals in Ireland, including level of service provision, if any, available for children with (C)APD. The aim of Phase 2 was to explore the initial steps required to develop an integrated service for children presenting with (C)APD. METHOD: A quantitative design was used in Phase 1, and 520 surveys were distributed to speech and language therapists, audiologic scientists, and educational psychologists. A qualitative participative design was used in Phase 2. RESULTS: There was a 53% response rate to the survey. The main findings from Phase 1 were that all professional groups considered themselves to be inadequately informed and lacking in skills for (C)APD assessment or intervention. In Phase 2, 98 participants with backgrounds in speech and language therapy, audiologic science, educational psychology, and occupational therapy engaged in interdisciplinary discussions to identify the first steps required to develop a (C)APD service. CONCLUSION: All professional groups considered that they were inadequately informed about (C)APD, and the first steps required to develop services in Ireland include the promotion and development of interdisciplinary teamwork and education, a need for additional resources, a clearer understanding of the definition of (C)APD, and evidence-based assessment and management of this condition.


Assuntos
Serviços de Saúde da Criança , Transtornos do Desenvolvimento da Linguagem , Audiologia , Criança , Serviços de Saúde da Criança/organização & administração , Humanos , Irlanda , Transtornos do Desenvolvimento da Linguagem/diagnóstico , Transtornos do Desenvolvimento da Linguagem/terapia , Terapia da Linguagem , Psicologia Educacional , Fonoterapia
11.
Int J Speech Lang Pathol ; 10(6): 425-37, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-20840022

RESUMO

Three criteria for diagnosing specific language impairment (SLI) are defined in the literature: exclusionary definitions, inclusionary definitions, and qualitative markers. However, the assessment and diagnosis of this complex impairment in clinical practice can be challenging. The aims of this research were twofold: (1) to make explicit the current assessment procedures which speech and language therapists (SLTs) use when they diagnose children with SLI in Ireland, and (2) to explore SLT's perceptions and experiences of the process of diagnosing children with SLI. Both quantitative and qualitative methods were used in this study. A survey of 199 SLTs in Ireland was carried out to address aim one and a focus group was conducted to address the second aim. The findings were that SLTs use exclusionary and inclusionary definitions of SLI, and qualitative markers when assessing children who they suspect may have SLI. SLTs in Ireland consider a diagnosis of SLI when children present with a verbal-performance discrepancy, a positive family history, word finding difficulties and lack of progress in therapy. The results of the qualitative strand indicated that assessment and diagnosis of children with SLI is a complex, time-consuming process involving other professionals. What emerged was a complex picture with tensions between therapists' professional judgements, policy, evidence-based practice and resources.

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