Communication-related aspects of prospective memory: an exploratory factor analysis of prospective memory questionnaires.

PURPOSE: Prospective memory (PM) questionnaires are frequently used to evaluate perceptions of PM skills in daily life. This study aimed to systematically investigate communication-specific attributes using pre-existing PM self-rating questionnaires to inform clinicians and researchers about the role of PM in cognitive communicative evaluations. METHODS: PM-related items from three questionnaires (i.e., Prospective Memory Questionnaire, Comprehensive Assessment of Prospective Memory, and Prospective and Retrospective Memory Questionnaire) were compiled and embedded in Google Forms and distributed to 70 Speech-Language Pathologists (SLPs) with expertise in Cognitive Communicative Disorders across India. Participants first identified items related to communication, and were then contacted to rate the communication-related PM items using a Likert scale for their degree of appropriateness. Responses from 40 SLPs were obtained and subjected to item-content validity index (i-CVI) and exploratory factor analysis (EFA). RESULTS: Of the 114 PM items, 28 received ratings over 50% for their relevance to communication. Of the 28 items, 21 had an i-CVI score greater than 0.8. After the removal of overlapping content, 14 items were finalized and subjected to EFA, which resulted in four factors: PM failure due to loss of communicative content, PM failure due to loss of communicative intent, PM cost due to ongoing interference, and PM failure linked to the priority of communicative intent. CONCLUSION: This study highlights communication-related aspects of PM that can be used as a framework for SLPs to assess and research PM skills.

Pedagogical Approaches to Cultural and Linguistic Diversity in Communication Sciences and Disorders Programs: A Nationwide Survey.

PURPOSE: This study investigates how instructors in communication sciences and disorders (CSD) programs teach about cultural and linguistic diversity (CLD) in general-content courses as well as those dedicated to CLD content with the goal of identifying ways of improving training of preservice clinicians to provide culturally responsive service delivery. METHOD: A survey was sent to 4,192 instructors in CSD programs at 295 institutions in the United States and Puerto Rico, of which 565 responded. The survey contained choice response questions and open-ended questions. RESULTS: Curricular infusion as the sole strategy of CLD training has decreased since a similar survey was published by Stockman et al. (2008), while the number of programs that offer courses dedicated to CLD or use both strategies has increased. Dedicated CLD courses offer broader training in CLD issues and are considered more effective at preparing students to work with CLD populations. A number of challenges were identified, such as a lack of available resources or time to cover CLD issues. CONCLUSIONS: A combination of curricular infusion and dedicated CLD coursework is recommended to ensure sufficient training in CLD issues. The development of additional resources is needed to better support instructors in both general-content and CLD-dedicated courses. Finally, CLD training should engage students in challenging unjust systems and harmful ideologies and not just celebrate multiculturalism in order to provide culturally responsive service to all clients. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25587651.

Percepção das mães de pessoas com transtorno do espectro autista sobre cuidados no Sistema Único de Saúde / Perception of mothers of people with autism spectrum disorder about care in the Unified Health System

O Transtorno do Espectro Autista (TEA) surge nos primeiros anos de vida, mas sua trajetória inicial não é homogênea. Serviços de saúde pública e privada enfrentam desafios no que diz respeito ao diagnóstico e tratamento deste público, assim como no cuidado e orientação das famílias. Diante disso, esta dissertação possui como objetivo analisar a percepção das mães de pessoas com Transtorno do Espectro Autista sobre as práticas de cuidado direcionado ao bem estar das próprias mães que acompanham seus filhos nas unidades de atenção secundária do Sistema Único de Saúde (SUS), assim como as condições de acesso ao diagnóstico e o processo inicial do tratamento. Para tanto, optou-se realizar dois tipos de desenhos metodológicos, sendo um a revisão sistemática (registrado na plataforma PROSPERO sob o código de registro CRD42023394779) e o outro a abordagem qualitativa-descritiva realizada através de entrevistas semiestruturadas com quinze mães de pessoas com TEA registrado sob número de parecer 6.466.061 no Comitê de Ética do Hospital Universitário Onofre Lopes e que resultou em cinco artigos. Todos os artigos foram escritos entre janeiro de 2023 à junho de 2024. Os resultados da revisão sistemática (artigo 1) destacaram os desafios emocionais, sociais e econômicos dos pais de filhos com TEA e a importância do suporte emocional e comunitário para sua resiliência; o artigo 2 identificou barreiras significativas no SUS para o diagnóstico precoce de TEA, como a falta de profissionais especializados e a burocracia, sugerindo melhorias nas políticas públicas; o artigo 3 revelou a diversidade e inconsistência nos tratamentos de TEA disponíveis no SUS, enfatizando a necessidade de integração entre diferentes serviços de saúde para eficácia terapêutica; o artigo 4 constatou variações significativas nas práticas de cuidado na atenção secundária direcionado às mães que acompanham seus filhos nas consultas, destacando a importância da formação continuada dos profissionais de saúde e a padronização dos cuidados; já o artigo 5 abordou as experiências únicas das mães solteiras de pessoas com TEA, enfatizando a sobrecarga emocional e financeira e a necessidade de redes de suporte específicas; por fim o artigo 6 mostrou que o conhecimento das mães sobre TEA evolui ao longo do tempo, influenciando a eficácia do tratamento e ressaltando a importância de programas educacionais contínuos para os pais. Conclui-se então que esta dissertação oferece uma contribuição significativa ao aprofundar o entendimento das experiências das mães de pessoas com TEA a respeito da busca do diagnóstico e processo terapêutico dos seus filhos, assim como as práticas de cuidado nas unidades de atenção secundária do SUS. Os resultados obtidos sublinham a necessidade urgente de melhorar o acesso ao diagnóstico precoce, facilitar o início dos tratamentos, padronizar as práticas de cuidado e oferecer suporte contínuo às famílias. Para avanços futuros, sugere-se a realização de estudos longitudinais que acompanhem as famílias ao longo do tempo para entender melhor as mudanças nas percepções e nas necessidades de cuidado. É importante investigar a realidade de diferentes regiões do Brasil para obter uma visão mais abrangente das condições de acesso e tratamento. Também seria benéfico incluir perspectivas de outros cuidadores para uma compreensão mais completa do impacto do TEA. Por fim, é fundamental informar a criação de políticas públicas que abordem as lacunas identificadas na pesquisa, promovendo uma melhor integração e qualidade dos serviços de saúde oferecidos pelo SUS (AU).

Autism Spectrum Disorder (ASD) appears in the first years of life, but its initial trajectory is not homogeneous. Public and private health services face challenges when it comes to diagnosing and treating this population, as well as caring for and guiding families. Therefore, this dissertation aims to analyze the perception of mothers of people with Autism Spectrum Disorder regarding care practices aimed at the well-being of the mothers themselves who accompany their children in the secondary care units of the Unified Health System (SUS), as well as the conditions for access to diagnosis and the initial treatment process. To this end, it was decided to carry out two types of methodological designs, one being a systematic review (registered on the PROSPERO platform under the registration code CRD42023394779) and the other a qualitative-descriptive approach carried out through semi-structured interviews with fifteen mothers of people with ASD registered under opinion number 6.466.061 with the Ethics Committee of the Onofre Lopes University Hospital and which resulted in five articles. All articles were written between January 2023 and June 2024. The results of the systematic review (article 1) highlighted the emotional, social and economic challenges faced by parents of children with ASD and the importance of emotional and community support for their resilience; article 2 identified significant barriers in the SUS for the early diagnosis of ASD, such as the lack of specialized professionals and bureaucracy, suggesting improvements in public policies; article 3 revealed the diversity and inconsistency in ASD treatments available in the SUS, emphasizing the need for integration between different health services for therapeutic effectiveness; article 4 found significant variations in care practices in secondary care aimed at mothers who accompany their children to consultations, highlighting the importance of continued training for health professionals and the standardization of care; Article 5 addressed the unique experiences of single mothers of people with ASD, emphasizing the emotional and financial burden and the need for specific support networks; Finally, article 6 showed that mothers' knowledge about ASD evolves over time, influencing the effectiveness of treatment and highlighting the importance of ongoing educational programs for parents. It is therefore concluded that this dissertation offers a significant contribution by deepening the understanding of the experiences of mothers of people with ASD regarding the search for diagnosis and the therapeutic process of their children, as well as care practices in SUS secondary care units. The results obtained highlight the urgent need to improve access to early diagnosis, facilitate the initiation of treatments, standardize care practices and offer continuous support to families. For future advances, it is suggested that longitudinal studies be carried out that follow families over time to better understand changes in perceptions and care needs. It is important to investigate the reality of different regions of Brazil to obtain a more comprehensive view of access and treatment conditions. It would also be beneficial to include perspectives from other caregivers for a more complete understanding of the impact of ASD. Finally, it is essential to inform the creation of public policies that address the gaps identified in the research, promoting better integration and quality of health services offered by the SUS (AU).

Evidence of concurrent and predictive criterion validity of the Child Communication Screening Instrument from 0 to 36 months (IRC-36). / Evidências de validade de critério concorrente e preditiva do Instrumento de Rastreio da Comunicação de Crianças de 0 a 36 meses (IRC-36).

PURPOSE: To determine evidence of concurrent and predictive criterion validity of the Communication Screening Instrument for children aged 0 to 36 months (IRC-36). METHODS: 78 parents/guardians of children who attend the childcare service of the Family Health Centers participated in the research, in addition to 33 children aged between 0 and 36 months, invited to the second stage of the study. In its first stage, 13 health professionals were trained to apply the IRC-36 to the children's parents/guardians. In the second moment, the parents responded to a new IRC-36 application, and the children were evaluated with Denver II. RESULTS: IRC-36 correlated with Denver II in more than half of the cases, confirming the instrument's concurrent criterion validity. IRC-36 results in the first stage did not significantly correlate with Denver II. The instrument's cutoff value was 12, which is the reference value between children at risk and not at risk of communication disorders. The instrument had high sensitivity and an accuracy value within the recommended levels. The occurrence of risk of communication changes was higher in the second IRC-36 application. CONCLUSION: The study presented evidence of concurrent criterion validity, indicating that the instrument has evidence of accuracy and validity measures to screen communication in children aged 0 to 36 months, being able to identify the risk for communication disorders.

OBJETIVO: Determinar evidências de validade de critério concorrente e preditiva do Instrumento de Rastreio da Comunicação de crianças de 0 a 36 meses (IRC-36). MÉTODO: Participaram da pesquisa 78 pais/responsáveis de crianças que frequentam o serviço de puericultura das Unidades de Saúde da Família, além de 33 crianças com idades entre 0 e 36 meses, convidadas para segunda etapa do estudo. Na primeira etapa do estudo, 13 profissionais de saúde foram treinados para realizar a aplicação do IRC-36 nos pais/responsáveis das crianças. No segundo momento, os pais responderam a uma nova aplicação do IRC-36 e as crianças foram avaliadas com o Denver II. RESULTADOS: O IRC-36 apresentou correlação com o Denver II em mais da metade dos casos, confirmando a validade de critério concorrente do instrumento. Os resultados do IRC-36 da primeira etapa quando correlacionados com o Denver II, não apresentaram valores significativos. O valor de ponto de corte do instrumento foi 12, sendo este o valor de referência entre crianças em risco e sem risco para alteração da comunicação. O instrumento apresentou valor de acurácia dentro dos níveis preconizados e alta sensibilidade. A ocorrência de risco para alteração da comunicação apresentou-se maior na segunda aplicação do IRC-36. CONCLUSÃO: O estudo apresentou evidências de validade de critério concorrente, indicando que o instrumento possui evidências de medidas de acurácia e de validade para o rastreio da comunicação de crianças de 0 a 36 meses sendo capaz de identificar risco para as alterações da comunicação.

Method for Developing Communication Skills in Autism - DHACA: appearance and content validation. / Método de Desenvolvimento das Habilidades de Comunicação no Autismo ­ DHACA: validação da aparência e do conteúdo.

PURPOSE: To validate the appearance and content of the DHACA method to develop communication skills in autism. METHODS: This qualitative and quantitative validation study included 10 speech-language-hearing judges with expertise in alternative communication. The judges received the communication book, the description of the principles, skills, and strategies in the DHACA method, and a form with items for them to appraise the appearance and content of the method. The validity was calculated with the content validity index. RESULTS: The response analysis made it possible to calculate the degree of agreement between judges and develop the new instrument version. The calculation of the content validity index revealed excellent content validity. The judges made suggestions regarding the content of the communication book, texts regarding the participation of communication partners and modeling, using cues, and communicative skills. CONCLUSION: The degree of agreement between judges ensured the validation of the appearance and content of the DHACA method, considering the items alone and the whole instrument. Hence, its use can be recommended for speech-language-hearing clinical practice.

OBJETIVO: Validar a aparência e o conteúdo do método de Desenvolvimento das Habilidades de Comunicação no Autismo (DHACA). MÉTODO: Trata-se de estudo de validação de abordagem quali-quantitativa. Participaram do estudo dez juízes fonoaudiólogos com expertise na área da comunicação alternativa. Os juízes receberam o livro de comunicação, bem como a descrição dos princípios, habilidades e estratégias do método DHACA e um formulário com itens relativos à apreciação da aparência e conteúdo do método. A validade foi calculada usando o índice de validade de conteúdo. RESULTADOS: A análise das respostas possibilitou o cálculo do grau de concordância entre os juízes e a elaboração da nova versão do instrumento. O cálculo do Índice de Validade de Conteúdo revelou uma validade de conteúdo excelente. Os juízes deram sugestões referentes aos aspectos de conteúdo do livro de comunicação, nos textos de participação do parceiro de comunicação e modelagem, uso de dicas e habilidades comunicativas. CONCLUSÃO: O grau de concordância observado entre os juízes possibilitou a obtenção da validação da aparência e do conteúdo do método DHACA, considerando-se os itens isoladamente e o instrumento como um todo, podendo ter seu uso recomendado na prática clínica fonoaudiológica.

Speech Language Pathology interventions in the areas of breathing, chewing, swallowing and speaking: a scoping review. / Intervenções da Fonoaudiologia nas áreas de respiração, mastigação, deglutição e fala: uma revisão de escopo.

There are several types of approaches that can be used to achieve therapeutic goals in disorders related to the functions of mastication, swallowing, speech, and breathing. However, the literature lacks evidence to support their use in speech-language clinical practice. The objective of this review was to map the syntheses of evidence on speech-language pathology intervention in the areas of breathing, mastication, swallowing and speech in adults and the elderly. Only studies classified by their authors as a systematic review, studies that addressed therapy for orofacial disorders in individuals over 18 years of age were included. The procedures performed included: electronic and manual search; selection of studies; data extraction; evaluation of the quality of studies and data analysis. It was possible to observe different types of interventions mainly aimed at the swallowing function, ranging from traditional therapy to the use of devices. However, due to the limitations of the studies, the data must be interpreted with caution.

Há diversas abordagens que podem ser utilizadas para atingir os objetivos terapêuticos nos distúrbios relacionados às funções de mastigação, deglutição, fala e respiração. Entretanto, a literatura necessita de evidências que fundamentem o uso na prática clínica fonoaudiológica. O objetivo desta revisão foi mapear as sínteses de evidências sobre intervenção fonoaudiológica nas áreas de respiração, mastigação, deglutição e fala em adultos e idosos.‬ Foram incluídos apenas estudos classificados por seus autores como revisão sistemática, que abordaram terapia para disfunções orofaciais em indivíduos maiores de 18 anos. Os procedimentos realizados foram: busca eletrônica e manual; seleção dos estudos; extração dos dados; avaliação da qualidade dos estudos e análise de dados. Foi possível observar diversos tipos de intervenções principalmente voltadas à função de deglutição, abarcando desde a terapia tradicional até a utilização de dispositivos. Contudo, devido às limitações dos estudos, os dados devem ser interpretados com cautela.

Public health training in public institutions' speech-language-hearing programs in Northeastern Brazil: a curricular framework study. / A formação em saúde coletiva nos cursos de fonoaudiologia de instituições públicas do Nordeste: um estudo a partir das matrizes curriculares.

PURPOSE: To describe the characteristics of the initial public health training for speech-language-hearing therapists in Northeastern Brazil. METHODS: The research was based on the curricular framework of public higher education institutions in the Northeast. The analysis approached each institution's general speech-language-hearing program data (state where it is located, total course load, and most recent curricular framework reformulation) and specific data on public health courses (their individual course load, the term when it is offered, syllabus content, whether it was theoretical, practical, both, or internship, and whether it was required or elective). RESULTS: The data show that eight public higher education institutions in the Northeast offer speech-language-hearing programs, whose pedagogical frameworks date from 2009 to 2021. The total course load of those related to public health ranges from 7.5% to 20.5% of the total program among those analyzed. Most courses were elective, exclusively theoretical, and were offered in the first half of the program. CONCLUSION: The initial public health training for speech-language-hearing therapists in public higher education institutions in the Northeast still seems to be based on traditional practices. These create a distance between students, public health, and practices that meet the principles of Health Unic System (in Portuguese - Sistema Único de Saúde) and the population's real needs, especially in primary healthcare.

OBJETIVO: Descrever as características da formação inicial em saúde coletiva de fonoaudiólogos do Nordeste do Brasil. MÉTODO: A pesquisa foi realizada com base nas matrizes curriculares de Instituições de Ensino Superior (IES) públicas do Nordeste a partir das quais foram analisados dados gerais dos cursos de Fonoaudiologia de cada Instituição ー estado em que está localizado, carga horária total e última reformulação de matriz curricular; e dados que diziam respeito especificamente às disciplinas relacionadas à Saúde Coletiva ー carga horária de cada disciplina, semestre de oferta, conteúdo da ementa, caráter teórico, prático, teórico-prático ou estágio, se obrigatória ou optativa. RESULTADOS: Os dados revelam que existem oito IES públicas do nordeste que oferecem o curso de Fonoaudiologia, sendo que os Projetos Pedagógicos de Cursos datam de 2009 a 2021. A Carga Horária (CH) total das disciplinas vinculadas à área de Saúde Coletiva varia de 7,5% a 20,5% da CH total dos cursos analisados. A maioria destas disciplinas é eletiva, tem caráter teórico e é ofertada na primeira metade da formação. CONCLUSÃO: A formação inicial em saúde coletiva de fonoaudiólogos de IES públicas do nordeste parece ainda estar embasada em práticas tradicionais, que acabam distanciando os discentes do campo da saúde coletiva e de práticas que atendam os princípios do Sistema Único de Saúde, e as reais necessidades da população, especialmente na Atenção Primária à Saúde.

A Delphi survey-based development and validation of cognitive-communication assessment tool for Indian preschoolers.

PURPOSE: To address the need for a standardized assessment tool for assessing cognitive-communication abilities among Indian preschoolers, the current study aimed at describing a Delphi based development and validation process for developing one such tool. The objectives of the research were to conceptualize and construct the tool, validate its content, and assess its feasibility through pilot testing. METHODS: The study followed a Delphi approach to develop and validate the tool across four phases i.e. conceptualization; construction; content validation; and pilot testing. The first three phases were performed with a panel of six experts including speech-language pathologists and preschool teachers while the pilot testing was done with 20 typically developing preschoolers. A literature review was also conducted with the Delphi rounds to support the developmental process. RESULTS: The first two rounds of the Delphi aided in the construction of a culturally and linguistically suitable story-based cognitive-communication assessment tool with the memory (free recall, recognition, and literary recall) and executive function (reasoning, inhibition, and switching) related tasks relevant for preschoolers. The content validation of the tool was continued with the experts till the revisions were satisfactory and yielded an optimum Content Validity Index. The pilot test of the finalized version confirmed its feasibility and appropriateness to assess developmental changes in the cognitive-communication abilities of preschoolers. CONCLUSION: The study describes the Delphi-based conceptualization, construction, content validation, and feasibility check of a tool to assess cognitive-communication skills in preschool children.

Linking Clinic With Classroom in Intensive Focused Preservice Education on Augmentative and Alternative Communication.

PURPOSE: This article reports a pilot study that combined clinical training and academic instruction in a graduate-level augmentative and alternative communication (AAC) course. The authors aim to (a) provide a detailed description of the AAC course and (b) present preliminary data regarding the graduate students' perception on the AAC course and their own competencies in AAC. METHOD: Forty-three graduate students completed an intensive focused course that included AAC fieldwork (i.e., direct clinical service and caregiver training) as well as academic content. In delivering the clinical and academic content, the course instructor followed the principles of problem-based learning. During their final semester in the graduate program, the students completed a survey regarding the AAC course and their self-efficacy in AAC services. RESULTS: Thirty-eight among the 43 students perceived that the AAC fieldwork, embedded into the AAC course, made them feel competent or strongly competent. The entire 43 respondents listed the AAC fieldwork as the component that they liked in the AAC course. When students were asked about their self-efficacy in AAC services at three different time points (i.e., before taking the AAC course, after taking the AAC course, and at the time of the survey), their ratings were significantly higher for after taking the AAC course and at the time of the survey, compared to before taking the course. CONCLUSION: This study suggests the significance of compulsory fieldwork embedded in the AAC training as evidenced by the graduate students' subjective perception of competence and preparedness in AAC services following the AAC course.

A Mixed-Methods Analysis of Speech-Language Pathologists' Executive Function Services.

PURPOSE: The purpose of this study was to examine school-based speech-language pathologists' (SLPs') implementation of services to address students' executive function (EF) needs, with particular emphasis on the prevalence and characteristics of EF interventions and the factors and barriers that influence service provision for students with EF needs. METHOD: We applied an explanatory sequential mixed-methods research design, beginning with a quantitative survey followed by a series of qualitative interviews. We analyzed the survey results using descriptive data and binary logistic regressions and used the emergent trends to inform our interview protocol, so that we could explore those trends in greater detail and context. We synthesized our quantitative and qualitative data to evaluate the characteristics of EF interventions and the factors influencing services. RESULTS: Most SLPs reported that they addressed their students' EF needs through some sort of direct or indirect intervention. Direct interventions varied by targeted domain, service delivery setting, and teaching techniques, though most SLPs favored strategy instruction and highly contextualized services. Indirect services included accommodations and consultation. SLPs commonly reported the lack of collaborative support, time, and knowledge as barriers, and most reported that professional development would be helpful to improve their services. CONCLUSIONS: Speech-language pathology graduate programs and providers of professional development should be mindful of their role in preparing SLPs to address EF needs, while SLPs may use these results to inform their own practice. Further guidance and research are necessary to elucidate the SLPs' role in mitigating the negative impact of EF challenges on students' education. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.24101241.

ICF and perception of functioning according to children/adolescents in follow-up with speech/language disorders.

PURPOSE: To characterize changes in the functioning aspects, in the perception of children and adolescents with speech and language disorders under speech-language follow-up, using the ICF. METHODS: Descriptive, analytical and longitudinal research, with a qualitative and quantitative approach, whose sample consisted of 60 children and adolescents: 30 with speech and language disorders and 30 with typical speech and language development. Data collection was carried out in two moments: beginning of the research and six months later. A semi-structured questionnaire was administered to the participants, and a medical records analysis was performed. From these data, functioning was classified using he ICF categories. The Wilcoxon test and thematic content analysis were used to compare the interviews. RESULTS: The use of ICF allowed characterizing changes resulting from speech-language follow-up. Participants with speech and language disorders presented a decrease in the magnitude of the qualifiers in the categories: articulation and fluency, social relationships, daily activities, engagement in play, people's attitude barriers, and how to handle stress. CONCLUSION: The findings show changes in components of Body Functions, Activities and Participation, and the influence of Environmental Factors after speech-language follow-up, in the perception of the studied group, which brings relevant subsidies for a greater understanding of functioning and therapeutic intervention. The use of the ICF enabled the longitudinal analysis in a biopsychosocial approach, contemplating, in addition to biological aspects, the social impact of speech and language disorders in the lives of these children and adolescents.

Supporting Culturally Responsive Assessment Practices With Preschoolers: Guidance From Methods in the Jamaican Context.

PURPOSE: There is a shortage of available methods to accurately inform the developmental status of children whose cultural and linguistic backgrounds vary from the mainstream. The purpose of this review article was to describe different approaches used to support the accurate characterization of speech, language, and functional communication in children speaking Jamaican Creole and English, an understudied paradigm in the speech pathology research. METHOD: Approaches used across four previously published studies in the Jamaican Creole Language Project are described. Participants included 3- to 6-year-old Jamaican children (n = 98-262) and adults (n = 15-33). Studies I and II described validation efforts about children's functional communication using the Intelligibility in Context Scale (ICS; speech) and the Focus on the Outcomes of Communication Under Six (FOCUS; speech and language). Study III described efforts to accurately characterize difference and disorder in children's expressive grammar using adapted scoring, along with adult models to contextualize child responses. Last, Study IV applied acoustic duration (e.g., whole word) and an adapted scoring protocol to inform variation in speech sound productions in the Jamaican context where a post-Creole continuum exists. RESULTS: Studies I and II offered promising psychometric evidence about the utility of the ICS and the FOCUS. Study III revealed strong sensitivity and specificity in classifying difference and disorder using adult models. Last, in Study IV, linguistically informed acoustic analyses and an adapted protocol captured variation in speech productions better than a standard approach. CONCLUSIONS: Applying culturally responsive methods can enhance the accurate characterization of speech, language, and functional communication in Jamaican children. The innovative methods used offer a model approach that could be applied to other linguistic contexts where a mismatch exists between speech-language pathologists and their clientele. PRESENTATION VIDEO: https://doi.org/10.23641/asha.23929461.

Perspectives of Indian speech language pathologists towards assessing adolescents with language impairments.

PURPOSE: Perspective-based studies have been carried out on health professionals to create clinical implications that will positively impact the healthcare system. There are no such studies exploring the perspectives of Indian speech language pathologists (SLPs) towards handling adolescents with language impairments. Therefore, the current study aims to explore the perspectives of Indian SLPs on the assessment of adolescent language. METHODS: The study followed a cross-sectional study design following a non-random convenient sampling procedure. A total number of 102 SLPs participated in the study. Phase 1 comprised developing a questionnaire to identify the perspectives of SLPs towards the assessment of adolescents with language impairments. A total of 9 questions were formulated for the same. Phase 2 included the data collection which was conducted through an online survey. Phase 3 focused on the data analysis. Descriptive statistics were to determine the mean and SD for continuous variables, and frequency and percentage for discrete variables. RESULTS: The current study results indicated significant disparities in the perspectives of SLPs towards adolescent language assessment. An overall level of poor awareness and a superficial understanding of the core area (about adolescence, and the areas and tools for assessment) was evident. CONCLUSION: Understanding the perspectives of SLPs towards adolescent language assessment is critical in paving the way for future clinical development and research.

Collaborative Commentary for Understanding Communication Disorders.

PURPOSE: The goal of the Collaborative Commentary (CC) system is to make the TalkBank adult clinical databases-including AphasiaBank, DementiaBank, RHDBank, and TBIBank-open to commentary and analysis from the full community of researchers, instructors, students, and clinicians. METHOD: CC allows a group leader to establish a commentary group and invite colleagues or students to join as members of the group. Members can then browse through the transcript database using the TalkBank Browser. When they wish to insert a comment, they click on the utterance line number or drag the cursor across a range of utterances and a window opens to receive the comment. The comment can include open text along with codes selected from a predefined set of codes created by that commentary group. RESULTS: CC was released for public use in August 2022. It is being used currently in five research projects and eight classes. An important feature of CC is its ability to evaluate the reliability of coding systems and to sharpen analytic categories. By familiarizing instructors and researchers with the capabilities of CC, we expect to see an increasing usage of CC for a variety of clinical and research applications. CONCLUSIONS: CC can contribute to a better understanding of connected speech features in aphasia, dementia, right hemisphere disorder, and traumatic brain injury. CC represents an extreme innovation not only for the study of adult neurogenic communication disorders but also for the study of spoken language generally.

Assessment of mouth breathing by Speech-Language Pathologists: an international Delphi consensus.

PURPOSE: mouth breathing (MB) has detrimental effects on children's growth. Diagnosis of MB is possible through a multidisciplinary approach including Speech-Language Pathologist's (SLP) assessment; however, SLPs currently have little to no defined selection criteria to determine the awake and habitual breathing pattern. This study aims at identifying relevant criteria for the assessment of the habitual and awake breathing pattern of preschool children, and developing a grid that would help SLPs diagnose MB in their clinical practice. METHODS: A three-rounded online international Delphi process was conducted to achieve a consensus on the relevant items and their interpretation. Agreement was established through a Content Validity Ratio calculation. Based on the agreed items, we developed a grid through a scoring function. RESULTS: Observing the child at rest (i.e., time spent with an open/closed mouth and position of the tongue/lips) was considered the most important criterion. The experts also considered that observing the breathing pattern while chewing (open/closed mouth) and after swallowing (i.e., air intake and open/ closed mouth just after swallowing) should provide relevant but secondary information in decision-making. We were able to establish a clinical grid based on those criteria. CONCLUSION: The Delphi procedure provided content-valid criteria and conditions of observation for the myofunctional SLP assessment of the awake and habitual breathing pattern in preschoolers. A clinical validation of the developed prototype grid should be conducted in preschool children to explore its effectiveness in the diagnosis of MB.

Clinically Applicable Sociolinguistic Assessment for Cognitive-Communication Disorders.

PURPOSE: The third International Cognitive-Communication Disorders Conference was held in early 2022, providing an opportunity for researchers and clinicians to discuss management of cognitive-communication disorders (CCDs). Presentations that addressed social discourse initiated broader conversations about implementing sociolinguistic methods in research and clinical contexts. Given the heterogeneity of CCDs and sociocultural contexts, a person-centered approach is needed. Sociolinguistic methods are inherently relevant and salient to the individual's communication context and partners. Sociolinguistic analyses provide information about language skills, cognitive-communication skills, and social cognition. The purpose of this article is to share a model of social communication and provide descriptions of current methods that can be used by researchers and clinicians to capture the complexity of social communication, thereby advancing our knowledge and practice. CONCLUSION: Although there is a growing literature base that supports the inclusion of sociolinguistic methods, there remains a disconnect between the literature and clinical application that current researchers and practitioners have an opportunity to address. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.21614268.

Designing a cyber-physical robotic platform to assist speech-language pathologists.

This research focused on the development of a cyber-physical robotic platform to assist speech-language pathologists who are related to articulation disorders in education environments. The first goal was the design and development of the system. The second goal was the qualitative initial validation of the platform with robotics and mobile device functionalities drawing on the participation of real patients and speech-language pathologists (SLP). The research method is based on qualitative data. The first phase was the application of engineering requirements and agile techniques to build the robotic system. The second phase was to execute test sessions of the robotic platform with speech-language pathologists supervision and analyzing the experience of real male and female patients collecting data by in-depth interviews and video recordings at Heredia Special Education Center in Costa Rica. The practical approach of the cyber-physical platform has preliminarily support. Testing with SLPs and 3 other older individuals suggests that it may become a useful tool to assist professionals in the treatment of some types of articulation disorders. The time savings and data collection possibilities should be included in future investigations of efficacy.

Psicólogas(os) no sistema educacional de Boa Vista/Roraima: concepções, práticas e desafios / Psychologists in the educational system of Boa Vista/Roraima: conceptions, practices and challenges / Psicólogas(os) en el sistema educativo de Boa Vista/Roraima: concepciones, prácticas y retos

O objeto de estudo deste trabalho é a atuação de psicólogas(os) no campo da educação básica. Tivemos como objetivo investigar as práticas de atuação e os desafios enfrentados pelas(os) psicólogas(os) que trabalham na educação em Boa Vista (RR), com intuito de conhecer a inserção desses profissionais no sistema educacional. Trata-se de pesquisa qualitativa, orientada pelo referencial teórico-metodológico da Psicologia Escolar Crítica. Realizamos o processo de levantamento dos dados entre os meses de março e abril de 2018, por meio de entrevistas semiestruturadas, audiogravadas e transcritas. Encontramos 21 psicólogas e um psicólogo trabalhando em instituições educacionais e de ensino na cidade; a maioria atuava na educação básica; metade dos entrevistados ingressou por concurso público e a outra metade era contratada e comissionada; poucos(as) foram contratados(as) como psicólogos(as) escolares. Para a análise, selecionamos dez psicólogas(os) com mais tempo no cargo. Quanto às práticas de atuação, identificamos que 60% atuavam na modalidade clínica e 40% na modalidade clínica e institucional. Como desafios, encontramos melhoria das condições de trabalho; estabelecimento de relações hierárquicas e a dificuldade de fazer compreender as especificidades desse campo de trabalho; necessidade na melhoria das condições para formação continuada; atuação da(o) psicóloga(o) escolar enquanto ação institucional. Diante do exposto, compreendemos ser necessária uma mudança de paradigma na atuação das(os) psicólogas(os) que trabalham na educação na região, e a apropriação das discussões da área, principalmente, aquelas apresentadas pela Psicologia Escolar Crítica, vez que esta contribui para uma atuação que leve em conta os determinantes sociais, políticos, culturais e pedagógicos que constituem o processo de escolarização.(AU)

This work has as object of study the role of psychologists in the field of Basic Education. We aimed to investigate practices and challenges faced by psychologists who work in education in Boa Vista/RR, to know the insertion of these professionals in the educational system. This is a qualitative research, guided by the theoretical-methodological framework of Critical School Psychology. The data collection process was carried out between March and April 2018, with semi-structured, audio-recorded, and transcribed interviews. We found 21 female psychologists and one male psychologist working in educational institutions in the municipality; most worked in Basic Education; half of the interviewees had applied to work as government employee and the other half were hired and commissioned; few were hired as school psychologists. To carry out the analysis, we selected ten psychologists with more time in the position. Regarding the practices, we have identified that 60% worked in the clinical modality and 40% in the clinical and institutional modality. As challenges, we find the improvement in working conditions; the establishment of hierarchical relationships and the difficulty of making the specificities of this field of work understood; the need to improve conditions for continuing education; the practice of the school psychologist as institutional action. In view of the above, we understand that a paradigm shift in the performance of psychologists working in education in that region is necessary, and the appropriation of discussions in the area, especially those presented by Critical School Psychology, contributes to an action that considers social, political, cultural, and pedagogical determinants that constitute the schooling process.(AU)

Este trabajo tiene como objeto de estudio la actuación profesional de las(os) psicólogas(os) en la educación básica. Su objetivo es investigar las prácticas y retos que enfrentan las(os) psicólogas(os) que trabajan en la educación en Boa Vista, en Roraima (Brasil), con la intención de conocer la inserción de estos profesionales en el sistema educativo. Esta es una investigación cualitativa que se guía por el marco teórico-metodológico de la Psicología Escolar Crítica. Se recopilaron los datos entre los meses de marzo y abril de 2018, mediante entrevistas semiestructuradas, grabadas en audio y después transcritas. Las 21 psicólogas y un psicólogo trabajan en instituciones educativas de la ciudad; la mayoría trabajaba en la educación básica; la mitad de los entrevistados ingresaron mediante concurso público y la otra mitad era contratada y de puesto comisionado; pocos fueron contratados como psicólogos escolares. Para el análisis, se seleccionaron diez psicólogas(os) con más tiempo en el cargo. Con respecto a las prácticas, el 60% trabajaba en la modalidad clínica; y el 40%, en la modalidad clínica e institucional. Los retos son mejora de las condiciones laborales; establecimiento de relaciones jerárquicas y dificultad para comprender las especificidades de este campo de trabajo; necesidad de mejorar las condiciones para la educación continua; y actuación dela (del) psicóloga(o) escolar como acción institucional. En vista de lo anterior, es necesario el cambio de paradigma en la práctica profesional de las(os) psicólogas(os) que trabajan en la educación de la región y la apropiación de las discusiones del área, especialmente las presentadas por la Psicología Escolar Crítica, que contribuye a una acción que tiene en cuenta los determinantes sociales, políticos, culturales y pedagógicos que constituyen el proceso de escolarización.(AU)

Percepções de familiares sobre uma rede de cuidados de saúde mental infantojuvenil / Family perceptions about a children's mental health network / Percepciones familiares sobre una red de atención de salud mental infantojuvenil

Este artigo pretende conhecer como a rede de cuidados em saúde tem se operacionalizado a partir da percepção de familiares de crianças com demanda de cuidado em saúde mental (SM). Foram realizados dois grupos focais, um com familiares da Atenção Básica (AB) e outro com familiares do Centro de Atenção Psicossocial Infantojuvenil (CAPSij), totalizando 15 participantes. Seguiu-se com a análise lexical do tipo classificação hierárquica descendente, com o auxílio do software R Interface, a fim de análises multidimensionais de textos e questionários (IRaMuTeQ), resultando em cinco classes: A Pílula Mágica; Forças e Fraquezas dos serviços; Procurando por ajuda; Aceitando o diagnóstico da criança e Onde procurei ajuda. Os resultados apontam para dificuldades presentes na AB em identificar e manejar situações de Saúde Mental Infantojuvenil (SMIJ), por meio de uma lógica ainda medicalizante. Ressalta-se que a escola é apresentada como lugar de destaque na produção da demanda por cuidado e a família ainda é pouco convocada à construção das ações. Conclui-se, então, que avanços ainda são necessários para operacionalização de um cuidado pautado nas diretrizes da política de SMIJ.(AU)

This article aims to know how the healthcare network has been operationalized from the perception of family members of children with demand for mental health care (MH). Two focus groups were held, one with family members from Primary Care (PC) and the other with family members from the Child Psychosocial Care Center (CAPSij), totaling 15 participants. A lexical analysis of the descending hierarchical classification type was performed with the help of the software R Interface for multidimensional analyzes of texts and questionnaires (IRAMUTEQ), resulting in five classes: The Magic Pill; Strengths and Weaknesses of services; Looking for help; Accepting the child's diagnosis; and Where did I look for help. The results point to difficulties present in PC in identifying and managing situations of mental health in children and adolescents (MHCA), with a medicalization logic. Note that the school is presented as a prominent place in producing the demand for care, and the family is still not very much involved in the actions. It is, thus, concluded that advances are still needed for operationalization of care guided by MHCA policy guidelines.(AU)

Este artículo tuvo por objetivo conocer cómo opera una red asistencial a partir de la percepción de familiares de niños con demanda de atención en salud mental (SM). Se realizaron dos grupos focales, uno con familiares de Atención Primaria (AP) y otro con familiares del Centro de Atención Psicosocial Infantojuvenil (CAPSij), totalizando 15 participantes. Se realizó análisis léxico del tipo clasificación jerárquica descendente con la ayuda del software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires (IRAMUTEQ), lo que resultó en cinco clases: "La píldora mágica"; "Fortalezas y debilidades de los servicios"; "En busca de ayuda"; "Aceptar el diagnóstico del niño" y "¿Dónde busqué ayuda?". Los resultados apuntan las dificultades presentes en AP para identificar y manejar situaciones de salud mental infantojuvenil (SMIJ) mediante una lógica aún medicalizante. La escuela tiene un lugar destacado en la producción de la demanda de cuidados y la familia aún no está muy involucrada en la construcción de acciones. Se concluye que se necesitan avances para ofertar una atención guiada por lineamientos de la política del SMIJ.(AU)

Research to Advance Health and Health Care Equity for People With Communication Disabilities: An Overview of Research Symposium Papers.

Presentation Video: https://doi.org/10.23641/asha.21235632.