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PubMed1976

Developmental assessment of Spanish grammar.

The Developmental Assessment of Spanish Grammar (DASG) provides a language analysis procedure for Spanish-speaking children similar to the Developmental Sentence Scoring (DSS) procedure in English. The DASG is not an attempted translation of the DSS but was developed independently, taking into consideration the present knowledge of Spanish language acquisition. The purpose of the DASG is to evaluate the language of children with deficient grammatical skills in Spanish and to serve as a model for structuring Spanish language therapy. Proposed syntactic hierarchies for the following six grammatical categories are presented: indefinite pronouns and noun modifiers, personal pronouns, primary verbs, secondary verbs, conjunctions, and interrogative words. Weighted scores are assigned to groups of structures within the hierarchies and are used to score Spanish sentences children use spontaneously in conversation with an adult. The DASG was standardized on 128 Spanish-speaking children between the ages of 3.0 and 6.11 years. Norms and reliability measures are presented.

Chicago↗

PubMed2001

'Do you speak practice-ese?' A discourse of practice for sharing communication.

Speech and language therapy (SLT) is absorbed in an empirical (or 'scientific') discourse. A case study, involving a single practitioner, is reported. SLT's application of an empirical discourse is critically investigated. Results reveal that SLT engages reductionism, essentialism, and 'dis-othering' in its practice discourse. Consequently, rich, textured lives are re-manufactured in a less than authentic manner. A critically oriented practice discourse is recommended to assist SLT in reconsidering its present immersion in a reductionistic, technical and utilitarian discourse and toward a discourse that assists an effective sharing of communication.

Humans↗

PubMed2001

A strategic approach to clinical placement learning.

There are different ways of approaching the nationally reported shortages of clinical placements for speech and language therapy students in the UK. Viewing the problem as a simple issue of high demand and shortfall may result in seeking short-term solutions. However, in order to achieve effective longer term change, there is a need for an examination of the underlying aspects of the problem. In this paper the development and implementation of one department's clinical and professional strategy are described and some of the outcomes presented. It is suggested that strategic, long-term approaches also need to be considered more widely and that a national professional strategy should be developed.

Education, Professional↗

PubMed2001

Students' expectations of learning key skills and knowledge.

Students' expectations of the key skills and knowledge they acquire and how their perceptions of these change during the four year period of their speech and language therapy (SLT) degree programme are explored. This is important because students are central to the teaching and learning process so their expectations of learning have to be taken into account in order to best help them to achieve the required learning outcomes. Over 100 De Montfort University (DMU) SLT under-graduate students from the four years were surveyed by questionnaire. The research findings are discussed to examine the significance of differences between and within year cohorts. The outcomes of this research will provide a basis for recommendations for DMU and other universities' SLT programmes, and for the improvement of student learning guidance.

Health Knowledge, Attitudes, Practice↗

PubMed1995

Deafness in childhood: 2. Are deaf children getting the education they need?

Under the 1981 Education Act, deaf children should be assessed for a "Statement of Educational Needs". Deaf children under school age are supported by a peripatetic teacher for the deaf. There are different schools of thought about the best methods for teaching deaf children. Systems include the oral/aural, "Total Communication" and sign language methods Speech and language therapy is important but provision in schools is patchy and there may be disputes about whether it comes under the education or health budget. Ideally, each health district should have a District Children's Hearing Assessment Unit, which accepts self-referrals as well as referrals from professionals. The National Deaf Children's Society recommends that each child should have a key worker to co-ordinate the various services. At present the quality of schooling and support a deaf child receives is patchy and depends on the luck of where the parents happen to live.

Child↗

PubMed2001

An audit of the application of care aims across the south west Thames region.

Care aims are a means of defining the purpose of intervention of health care. The Malcomess care aims model uses these labels to guide the planning, delivery and outcome measurement of care. Within speech and language therapy (SLT) this involves the use of one of seven labels which clarify and make explicit the purpose of each episode of care undertaken with a client. This relatively simple application has been shown to change the way SLTs work, clarifying expectations of many who use the service. In the South West Thames Region, a project was put in place for SLTs which included undertaking training, audit and support. The outcome of the audit showed that care aims had been adopted across the region in a sufficiently flexible way to meet local needs and offered therapists the tools to reflect on the types of interventions provided to clients.

England↗

PubMed2001

Sharing learning through narrative communication.

This paper examines key aspects of the learning experiences of ten speech and language therapy (SLT) students on clinical placements, as revealed by an analysis of 102 narrative accounts. We argue that when students on placements tell stories of their learning experiences the process of recounting them can help them to reflect on and consolidate what they have learned and to have this learning validated by peer, clinician or tutor audiences. Thus, sharing learning through narrative communication is itself further learning from the original experience. We show how students evaluate their learning experiences, how their growing confidence is mediated by clinicians and how such narratives are shared in normal student interaction. Tutors might use the insights from narrative learning to raise students' awareness of their own learning, and thus to improve it.

Education↗

PubMed2001

An integrated multi-media package for learning clinical phonetics and linguistics.

Competence in the phonetic and linguistic analysis of normal and disordered spoken language is a basic requirement for all students and practitioners of speech and language therapy. This paper presents a learning package specifically designed for individuals who need to acquire or update practical skills and theoretical knowledge in clinical linguistic analysis. VISUAL-CLIP (VIdeo SUpported Active Learning in Clinical LInguistics and Phonetics) is a student-centred, interactive, multi-media tutorial in clinical linguistics and phonetics, based on digitised video- and audio-taped speech data from a child with a complex communication disorder. Data can be analysed from different perspectives and at different levels of difficulty using separate but inter-linked modules on phonetics, phonology, grammar, semantics and pragmatics. Case history information, formal assessment results, theoretical background and an annotated bibliography are also integrated into the CD-ROM based package.

Communication Disorders↗

PubMed1994

The treatment of acquired aphasia.

A number of large-scale trials have established that language therapy with acquired aphasic patients can result in significant improvement. However, such trials use a variety of different treatments with patients with qualitatively varying disorders. The group results give no information about the treatments that were effective for particular types of problem. More recent studies of treatment have examined the effects of more closely defined treatments for more closely defined disorders. Treatment based on the facilitation of word retrieval show quite long-lasting effects from limited amounts of treatment, when the treatment gives either semantic or phonological information about the word, but the improvements are mostly limited to the items involved in treatment. The establishment of strategies for word retrieval based on patients' retained abilities results in more generalized improvement. The need for studies that relate analysis of a patient's disorder more closely to the process of treatment is discussed.

Anomia↗

PubMedDate not supplied

Children's Communication Checklist (CCC) scores in 11-year-old children with communication impairments.

BACKGROUND: The pragmatic skills of children with communication disorders and their assessment are currently an issue for speech and language therapy and educational placement. AIMS: To explore whether different subgroups of children with communication disorders score differently on the Children's Communication Checklist (CCC) and to study how they compare with published normative data. METHODS & PROCEDURES: A sample of 161 eleven-year-old children with a history of communication disorders was assessed using the CCC. The main use of this questionnaire was to establish whether pragmatic impairments were part of a child's communication difficulty. Although the checklist was originally designed for research purposes, normative data for this scale have been recently published as well as group data from a number of different clinical groups. Whilst the present CCC data have been previously reported descriptively for a wider sample, they have not been examined in terms of subgroups or compared directly with normative information and similarly diagnosed individuals from other studies. OUTCOMES & RESULTS: Of the children assessed, 52 (33%) scored in the normal range (within 1 SD) on the pragmatic scale, 40 (26%) fell between 1 and 2 SD below the normative mean, and 64 (41%) scored below 2 SD of the mean of typically developing children (aged 6-16 years). Thus, the majority (67%) scored out of the normal range for pragmatic skill at 11 years of age. The cohort was separated into four diagnostic subcategories: those with a definite diagnosis of autistic spectrum disorder (n=15); those with typical specific language impairment (n=82); generally impaired (n=37); and those with a clinical history of primary pragmatic language impairment (independent of CCC score, n=27). CONCLUSIONS: Findings show that those generally impaired and with specific language impairment were less impaired than the other groups on the CCC pragmatic scale. There was a significant trend for those with autistic spectrum disorders to score lowest through pragmatic language impairment, generally impairment to specific language impairment. It is argued that a cut-off of 140 may prove more useful at this age than the 132 level previously published for 8 year olds. Results suggest that the CCC can be used as a clinical tool, but in conjunction with other reliable measures.

Autistic Disorder↗

PubMed2001

An inter-disciplinary approach to swallowing problems in acute stroke.

Many speech and language therapy (SLT) departments are in danger of being swamped with dysphagia referrals, often to the detriment of other work. At the same time surveys have shown that large numbers of patients with acute stroke have swallowing problems which are poorly managed during the critical early phase, not referred or missed altogether. The Collaborative Dysphagia Audit (CODA) study, carried out in six British hospitals, showed that nurses could quickly be trained to carry out basic screening assessments for dysphagia and that implementation of a co-ordinated inter-disciplinary dysphagia management policy (DMP) could substantially improve the proportion of dysphagic patients in whom appropriate feeding precautions were taken. These early DMPs were limited by the need for ward staff to keep all patients with suspected swallowing impairment nil by mouth until assessed by SLT, so in some acute stroke units nurses have been trained to a higher level which allows them to manage most routine transient swallowing problems, leaving only complex or persistent cases for referral to SLT. This approach has been used successfully in our unit in Gateshead, where a dysphagia nurse specialist post has been set up to act as a link between ward staff and SLTs, to ensure that the necessary training levels are maintained and to co-ordinate the DMP.

Acute Disease↗

PubMedDate not supplied

[Picture naming and imitation tests as tools for the diagnosis of phonological disorder].

BACKGROUND: phonological disorder. AIM: to verify the association between the phonological performance in picture naming and imitation tasks, assessing the occurrence of phonological processes and using the severity indexes of Percentage of Correct Consonants and Phonological Density Index. METHOD: participants of this research were 50 phonologically disordered children, with no history of prior speech-language therapy and with ages between 4:0 and 12 years. RESULTS: The analysis of the phonological processes indicated that the non-productive processes were more frequent than the productive ones, not only in the imitation task but also in the picture naming task. It was observed that in both tasks, most participants presented the phonological processes of cluster reduction, liquid simplification and final consonant deletion, independently of their productivity. When comparing both tasks, there was an association and agreement regarding the number of participants who presented phonological processes as well as a correlation regarding the total number of phonological processes; there was no evidence of differences concerning the averages of the phonological processes observed in the imitation and picture naming tasks; a negative correlation was observed between the severity indexes Percentage of Correct Consonants and Phonological Density Index; moreover, these values presented a strong correlation in both tests, indicating that they detect similar severity levels. CONCLUSION: the study verified an association and agreement between the picture naming and imitation tasks, not only for the number of participants who presented phonological processes, but also for the number of phonological processes, thus indicating the importance of using structured tests for the diagnosis of phonological disorder. Furthermore, for the severity indexes, Percentage of Correct Consonants and Phonological Density Index, a high correlation was observed between the tasks, indicating that both tasks are useful instruments in detecting phonological disorder.

Articulation Disorders↗

PubMed2001

Are overreferrals on developmental screening tests really a problem?

BACKGROUND: Developmental screening tests, even those meeting standards for screening test accuracy, produce numerous false-positive results for 15% to 30% of children. This is thought to produce unnecessary referrals for diagnostic testing or special services and increase the cost of screening programs. OBJECTIVES: To explore whether children who pass screening tests differ in important ways from those who do not and to determine whether children overreferred for testing benefit from the scrutiny of diagnostic testing and treatment planning. METHODS: Subjects were a national sample of 512 parents and their children (age range of the children, 7 months to 8 years) who participated in validation studies of various screening tests. Psychological examiners adhering to standardized directions obtained informed consent and administered at least 2 developmental screening measures (the Brigance Screens, the Battelle Developmental Inventory Screening Test, the Denver-II, and the Parents' Evaluations of Developmental Status) and a concurrent battery of diagnostic measures, including tests of intelligence, language, and academic achievement (for children aged 2(1/2) years and older). The performance on diagnostic measures of children who failed screening but were not found to have a disability (false positives) was compared with that of children who passed screening and did not have a disability on diagnostic testing (true negatives). RESULTS: Children with false-positive scores performed significantly (P<.001) lower on diagnostic measures than did children with true-negative scores. The false-positive group had scores in adaptive behavior, language, intelligence, and academic achievement that were 9 to 14 points lower than the scores of those in the true-negative group. When viewing the likelihood of scoring below the 25th percentile on diagnostic measures, children with false-positive scores had a relative risk of 2.6 in adaptive behavior (95% confidence interval [CI], 1.67-4.21), 3.1 in language skills (95% CI, 1.90-5.20), 6.7 on intelligence tests (95% CI, 3.28-13.50), and 4.9 on academic measures (95% CI, 2.61-9.28). Overall, 151 (70%) of the children with false-positive results scored below the 25th percentile on 1 or more diagnostic measures (the point at which most children have difficulty benefiting from typical classroom instruction) in contrast with 64 (29%) of the children with true-negative scores (odds ratio, 5.6; 95% CI, 3.73-8.49). Children with false-positive scores were also more likely to be nonwhite and to have parents who had not graduated from high school. Performance differences between children with true-negative scores and children with false-positive scores continued to be significant (P<.001) even after adjusting for sociodemographic differences between groups. CONCLUSIONS: Children overreferred for diagnostic testing by developmental screens perform substantially lower than children with true-negative scores on measures of intelligence, language, and academic achievement-the 3 best predictors of school success. These children also carry more psychosocial risk factors, such as limited parental education and minority status. Thus, children with false-positive screening results are an at-risk group for whom diagnostic testing may not be an unnecessary expense but rather a beneficial and needed service that can help focus intervention efforts. Although such testing will not indicate a need for special education placement, it can be useful in identifying children's needs for other programs known to improve language, cognitive, and academic skills, such as Head Start, Title I services, tutoring, private speech-language therapy, and quality day care.

Bias↗

PubMed1976

A factor-analytic study of criteria for evaluating student clinicians in speech pathology.

This study was designed to determine the most significant criteria used in university training programs to evaluate the therapeutic effectiveness of student clinicians enrolled in clinical practicum. A total of 152 supervisors in 53 ASHA accredited training programs used 40 criteria to evaluate 207 clinicians engaged in speech and language therapy. Factor analysis yielded two distinct dimensions, Technical Skills and Interpersonal Relationship Factors, and indicated that 18 variables contributed most significantly to the evaluative process. Student clinicians were consistently rated higher on variables related to the interpersonal dimension than on those related to technical skills. The identification and structure of the 18 variables suggests that both technical and interpersonal skills are widely regarded as essential to therapeutic effectiveness. The results provide insight into the nature of clinical evaluation and behavior and suggest a restructuring of criteria for evaluating the process of therapeutic treatment.

Clinical Competence↗

PubMed1980

Language gains in global aphasia over a three-year period: a case study.

A diagnosis of global aphasia generally suggests poor prognosis for recovery and indicates short-term therapeutic intervention. This case study illustrates language gains made by a patient with global asphasia over a three-year period of speech and language therapy. Prognostic factors against recovery include post middle age; right-handedness; extensive vascular damage; perceptual, sensory, and motor problems; and dysarthric and apraxic involvements associated with aphasia. Despite known patterns of recovery that indicate a six-month plateau in patients with global aphasia, the data on this patient indicates that long-term therapy, in certain cases, is appropriate and necessary.

Aphasia↗

PubMed2005

[Comparison of prescriptions by pediatricians and general practitioners: a population-based study in Franche-Comté from the database of Regional Health Insurance Fund].

OBJECTIVES: To compare the medical management of children by private pediatricians or by general practitioners. POPULATION AND METHODS: A retrospective cohort study analyzed information from the automated database of the Regional Health Insurance Fund for salaried workers in Franche-Comté from January 2001 through December 2002 and compared the mean rates of prescriptions in the populations seen only by general practitioners or mainly by pediatricians. RESULTS: Analysis concerned 1 535 208 visits (office and home). Management by pediatricians was associated with 25% fewer consultations and 6% fewer hospitalizations. Pediatricians also wrote 25% fewer prescriptions for drugs, 17% fewer for laboratory tests, and 42% fewer for speech and language therapy. Children seen by pediatricians took antibiotics much less often (penicillin: -24%; cephalosporins: -74%; macrolides: -53%) as well as half as many corticoids and NSAIDs. Their vaccination coverage was more complete (31% more hepatitis B vaccines, 7% more MMR), as was prevention against rickets and cavities (twice the rate of vitamin D and fluoride prescriptions). The population followed mainly by pediatricians included 25% more children with a chronic disease. CONCLUSION: General practitioners and pediatricians appear to differ significantly in their management of children. Other studies that can take into account such confounding factors as health status are needed to confirm these results.

Adolescent↗

PubMed2004

Organ donation and transplantation in Brazil: university students' awareness and opinions.

This study was aimed at assessing university students' awareness and opinions about aspects of the law no. 10.221/01. This exploratory study was performed among students at the São Paulo Federal University-UNIFESP, from 2001 to July 2002, including 1284 undergraduates in the following courses: nursing, medicine, speech and language therapy, biomedicine, and ophthalmic technology. That data show that 47.7% (333) of undergraduates are aware of the kind of donation established by the new law. Among the adolescents of first and second grades, and courses, there was a difference on the awareness about the kind of donation (P =.000). Most undergraduates (57.6%, 402) agree with consented donation. However, the high percentage--35.1% (245)--that chose the alternative "I don't know" is remarkable. Results show that many undergraduates are unaware of the specifications of the technical files for transplants; only 48.3% (337) of them chose the correct answer, and 79.4% (554) do not believe that the order in the waiting list for transplants is respected. The conclusion is that it is worth emphasizing is that there are different opinions and levels of awareness among students, considering age, religion and religious practice, and course and level at school. In spite of unawareness and lack of belief in the principles of distribution of organs and tissue, most students are willing to be donors (68.2%).

Adult↗

PubMedDate not supplied

Compensating for executive function impairments after TBI: a single case study of functional intervention.

UNLABELLED: The purpose of this study was to demonstrate the effectiveness of compensatory strategies for impairments in executive function. The strategies were designed to enable a client with traumatic brain injury (TBI) to obtain professional employment. In a series of individual speech-language therapy sessions, compensatory strategies were developed, refined, and trained in mock-interview situations. Significant improvements were noted in report-writing accuracy and self-reported stress during report-writing. The client was able to obtain and maintain competitive employment in his chosen profession. The results support the use of strategies aimed at supporting executive function to improve performance on verbal tasks, and were informative regarding the effects of self-perceived efficacy and stress on performance after TBI. They illustrate that intervention based on real-life supports may be effective even many years post-TBI. LEARNING OUTCOMES: At the conclusion of this article, readers will: (1) identify aspects of executive function that relate to communication in the workplace, (2) describe the steps in considering intervention within a single subject research design framework, and (3) consider the effects of stress and perceived self-efficacy on performance of communication tasks.

Brain Injuries↗