Biomedical subjects

S Roulstone

Publications and source records attributed to S Roulstone.

12 recordsLinked to original sources

PubMed2003

A 12-month follow-up of preschool children investigating the natural history of speech and language delay.

AIM: The aim of this paper is to examine the natural history of early speech and language delay in preschool children over a 12-month period. METHODS: The study reports data on 69 children under the age of 3.5 years who were referred for speech and language therapy because of early speech and language delay. The children were monitored over a 12-month period but received no direct intervention during that time. Assessment of their comprehension, expressive language and their phonology took place at baseline and again at 6 and 12 months after baseline. RESULTS: The results show a general picture of improvement, although there was considerable individual variation. By the end of the 12 months, two-thirds of the children were still eligible on the study intake criteria. Therapist's rating of a child's functional communication at the outset was a significant predictor of the child's outcome at the end of the 12-month period. DISCUSSION: The paper discusses the appropriateness of a 'monitoring' approach to the management of early language delay and highlights the need to consider the social issues and views of parents as well as the severity of a child's difficulties.

Articulation Disorders↗

PubMed2001

Day in, day out: the everyday therapy of community clinics.

This paper describes the timing and nature of therapy provided within a recent randomised controlled trial (RCT) of preschool speech and language therapy services. There is literature that describes and evaluates speech and language therapy but there is little indication of how this is translated into everyday practice. The study collected data from 21 speech and language therapists (SLTs) in 16 community clinics. The areas targeted, goals, approaches used, the frequency and timing of contact for the 68 children who received treatment were documented. The data show that several aspects of therapy were frequently targeted simultaneously, that approaches were combined and that the frequency of therapy did not vary with severity. The discussion will consider the gap between published programmes and everyday practice and the implications for effectiveness.

Child, Preschool↗

PubMed2001

Investigation of theoretical models and therapy activities: phonological difficulties.

A focus group of seven speech and language therapists (SLTs) who work with children with phonological difficulties was invited to share their views on their current ways of working. Qualitative data was generated through discussion of two video-taped recordings of children with phonological difficulties and a series of brainstorming tasks. The results indicate the use of an electric approach, a mixture of theories rather than a single one. Similarities and differences between SLTs are identified. Implications for the development of clinical guidelines and the investigation of effectiveness are discussed.

Child↗

PubMed2001

Who's afraid of the randomised controlled trial? Parents' views of an SLT research study.

Evidence-based health care is now a reality within the national health service (NHS) and the randomised controlled trial (RCT) is the linchpin of this movement. In modern health care, there has also been a shift towards understanding client perspectives. With regard to clients' participation in research, much consideration has been given to ethical issues and barriers to participation. However, less attention has been paid to the participants' views of clinical trials and understanding how they construe the research. This paper reports a study of the attitudes of parents whose children took part in an RCT. Data were collected from the parents of 20 children, using qualitative in-depth interviews. Parents talked about the meaning of their participation, their motivation for taking part and their understanding of the nature of the trial. The implications of the findings for future research will be considered.

Attitude↗

PubMed2000

Randomised controlled trial of community based speech and language therapy in preschool children.

OBJECTIVE: To compare routine speech and language therapy in preschool children with delayed speech and language against 12 months of "watchful waiting." DESIGN: Pragmatic randomised controlled trial. SETTING: 16 community clinics in Bristol. PARTICIPANTS: 159 preschool children with appreciable speech or language difficulties who fulfilled criteria for admission to speech and language therapy. MAIN OUTCOME MEASURES: Four quantitative measures of speech and language, assessed at 6 and 12 months; a binary variable indicating improvement, by 12 months, on the trial entry criterion. RESULTS: Improvement in auditory comprehension was significant in favour of therapy (adjusted difference in means 4.1, 95% confidence interval 0.5 to 7.6; P=0.025). No significant differences were observed for expressive language (1.4, -2.1 to 4.8; P=0.44); phonology error rate (-4.4, -12.0 to 3.3; P=0.26); language development (0.1, -0.4 to 0.6; P=0.73); or improvement on entry criterion (odds ratio 1.3, 0.67 to 2.4; P=0.46). At the end of the trial, 70% of all children still had substantial speech and language deficits. CONCLUSIONS: This study provides little evidence for the effectiveness of speech and language therapy compared with watchful waiting over 12 months. Providers of speech and language therapy should reconsider the appropriateness, timing, nature, and intensity of such therapy in preschool children. Continued research into more specific provision to subgroups of children is also needed to identify better treatment methods. The lack of resolution of difficulties for most of the children suggests that further research is needed to identify effective ways of helping this population of children.

Analysis of Variance↗

PubMed1999

Issues to consider in the evaluation of speech and language therapy for preschool children.

This paper reviews some of the methodological issues involved in the design of a randomized controlled trial currently underway in Bristol. The trial compares the progress of preschool children randomly allocated to a 'watching-waiting' control group with the experimental group who have immediate access to therapy. This paper reviews a number of relevant studies, which have either followed up preschool children with early language delays or have investigated the effects of therapy with this age group. The basic design of the trial is outlined along with a discussion of the sample, the measurements used and the therapy given.

Child, Preschool↗

PubMed1998

Running a randomised controlled trial in a service setting: a progress report.

This paper will give a progress report on a randomised controlled trial which is currently underway in the Bristol area. Some of the key influencing literature will be summarised, followed by an overview of the study design. The paper will also highlight some of the methodological and practical advantages and disadvantages afforded by the service setting of the study.

Child, Preschool↗

PubMed1997

What's driving you? A template which underpins the assessment of preschool children by speech and language therapists.

This paper presents a diagrammatic representation of features which underpin the initial assessment of preschool children newly referred to speech and language therapy. This model forms part of the results of a project whose overall aim was to make explicit the way in which expert speech and language therapists consider preschool children for intervention. Within a mainly qualitative methodology, data were collected by use of semistructured interviews, case analyses and a focus group workshop. The notational tool used for analysis, systemic grammar networks, is described and used to represent an assessment paradigm. The model is presented as a potential support for less experienced therapists or as a stimulus to reflection in more experienced therapists.

Child, Preschool↗

PubMed1994

Early identification of communication problems.

Questions have been raised about the effectiveness of routine early screening of children's speech development. Mary Gale et al describe an innovative package which can be used by health visitors and parents to ensure they correctly identify those children needing referral for specialist intervention.

Child↗

PubMed1983

Out of the broom cupboard.

Explore the source record for details and available documents.

Education of Persons with Intellectual Disabilitie↗

PubMedDate not supplied

Consensus and variation between speech and language therapists in the assessment and selection of preschool children for intervention: a body of knowledge or idiosyncratic decisions?

The aim was to investigate consensus between speech and language therapists (SLT) during the initial assessment of preschool children. A multimethod design was used. The qualitative component provided SLT's own views of the process as the starting point for the study. Data were generated from semistructured interviews and focus group discussions. The interviews investigated factors considered during an initial assessment of a preschool child. The focus groups discussed the process and content of a videotaped initial assessment carried out by the author. Quantitative data was generated from six case analyses and from a card sorting exercise. In the former, SLT were asked to record important features of newly referred cases. In the latter, SLT sorted statements about preschool children according to a simple concern/not concerned decision. Data collection tasks and analysis took place successively to build a composite and triangulated picture. The main subjects were 11 SLT, experienced in childrens' work with a further six acting as a broader reference group. The results show an interacting pattern of consensus and variation. SLT agreed about the relative priority of children, categories that informed the assessment; they made similar interpretations of incoming information. There was variation in their preferred assessment methods, in the thresholds of concern and in the interventions offered. Sources of variation that were identified included individual confidence in and access to assessments, personal levels of concern and in the approach to the SLT's role, as well as the influence of workplace policies. The study concluded that, consensus and variation both exist within the context of SLT's initial assessment of preschool children, but that there are discernible patterns to the variation. While such variation may be inevitable, it is suggested that any variation should be made explicit and used to challenge and develop the shared knowledge base of the speech and language therapy profession.

Child, Preschool↗

PubMedDate not supplied

Developing a scale to measure parental attitudes towards preschool speech and language therapy services.

In the past decade, there has been growing recognition of the need to involve clients in decisions about the healthcare they receive and in the evaluation of services offered. In health services research, survey and scaling methods have become important tools for research into 'consumer views' and the perspectives of people receiving healthcare. In spite of the increase in recent years in the participation of parents in their children's Speech and Language Therapy (SLT), there has been little attempt to investigate parents' perceptions and opinions of the services they receive. Moreover, there has been no previous attempt to derive a scale to measure these attitudes. The paper reports a study that explored the attitudes to therapy of 81 parents whose preschool children were receiving SLT intervention. Factor analysis of 12 items on a questionnaire revealed three issues salient in parental attitudes to therapy: practical help, emotional support and the perceived effectiveness of the service. The validity of these factors was supported by other findings from the questionnaire. The properties of the resulting scales are discussed and the ways in which they might be further refined and developed for use in SLT are suggested.

Attitude to Health↗