Introduction: This study examined speech language pathologists' use of standardized language measures when assessing school-aged children. Method: A total of 335 Speech Language Pathologist (SLP)s... Show moreIntroduction: This study examined speech language pathologists' use of standardized language measures when assessing school-aged children. Method: A total of 335 Speech Language Pathologist (SLP)s provided information in a web-based survey regarding the standardized language measures they use for school-aged children. SLPs were asked to identify the domains targeted, purposes of use and reasons for which regularly used standardized measures were chosen for use. Results: Findings indicated that SLPs collectively use many standardized measures, although only a small number are used regularly. SLPs reported using standardized measures to assess domains that measures are not ideally designed for and for purposes that the measures were not ideally suited to assessing. SLPs reported selecting diagnostic measures based on psychometric properties, but not for screening measures. Reasons for choice varied depending on the particular measure. Conclusion: Overall, findings indicated that SLPs need to place greater focus on evidence-based practice recommendations when selecting standardized measures for use with school-aged children. Implications for clinical practice and future directions are discussed. Show less
Isobe, Y.; Ouchi, M.; Suzuki, A.; Moriya, T.J.; Nakajima, K.; Nomoto, K.; ... ; Xu, Y. 2022
Purpose: Language intervention for children with language disorder may be effective; however, lack of detailed and consistent terminology for describing language interventions poses barriers for... Show morePurpose: Language intervention for children with language disorder may be effective; however, lack of detailed and consistent terminology for describing language interventions poses barriers for advancement within the field. This study aimed to develop consensus from speech-language pathologists (SLPs) in Australia on a taxonomy with terminology for describing language interventions for school-aged children and investigate SLPs' application of taxonomy terminology when describing child language interventions. Method: A taxonomy with terms for describing interventions was developed with reference to contemporary literature and presented to clinicians and researchers with expertise in child language disorders in a three-round Delphi study. We asked Delphi participants to indicate agreement with the taxonomy or propose changes. Application of the taxonomy was investigated by asking participants to use taxonomy terminology to describe interventions presented in two case studies. Results: The taxonomy consists of five aspects across which interventions may be described: modality/domain, purpose, delivery, form, and teaching techniques. Consensus on the taxonomy was established in both Round 1 (55 participants) and Round 2 (43 participants), with 100% of SLPs strongly agreeing or agreeing with the overall structure of the taxonomy and at least 87.3% of SLPs strongly agreeing or agreeing with each aspect. In Round 3 (32 participants), consensus was reached on 45/54 taxonomy categories (4/12 of the components) for Case Study 1 and 45/54 taxonomy categories (7/12 of the components) for Case Study 2. Conclusions: Consensus on a taxonomy with terminology for describing language interventions represents a significant advancement in the field of child language intervention. Future actions may be needed to facilitate consistent application of taxonomy terms. Supplemental Material: https://doi.org/10.23641/asha. 16435290 Show less
Denman, D.; Cordier, R.; Kim, J.H.; Munro, N.; Speyer, R. 2021
Purpose: This study reports on data from a survey of speech-language pathologists' (SLPs) language assessment practices for elementary school-age children. The objective was to investigate the... Show morePurpose: This study reports on data from a survey of speech-language pathologists' (SLPs) language assessment practices for elementary school-age children. The objective was to investigate the regularity with which SLPs use different types of assessments (described across data types, task types, environmental contexts, and dynamic features). This study also investigated factors that influence assessment practice, the main sources from which SLPs obtain information on language assessment and the main challenges reported by SLPs in relation to language assessment.Method: A web-based survey was used to collect information from 407 Australian SLPs regarding the types of assessments they use. Factors that influenced the regularity with which different types of assessments were used were investigated using regression analysis.Results: Most SLPs regularly used assessments that are norm-referenced, decontextualized, and conducted in a clinical context and less regularly used other types of assessments. Service agency, Australian state, and SLPs' years of experience were found to influence the regularity with which some types of assessments were used. Informal discussions with colleagues were the most frequently identified source of information on assessment practice. Main challenges related to limited time, lack of assessment materials, and lack of confidence in assessing children from culturally and linguistically diverse backgrounds.Conclusions: SLPs could improve current language assessment practice for elementary school-age children through more regular use of some types of assessments. Actions to facilitate evidence-based assessment practice should consider the contextual differences that exist between service agencies and states and address challenges that SLPs experience in relation to language assessment. Show less
Speyer, R.; Chen, Y.W.; Kim, J.H.; Wilkes-Gillan, S.; Nordahl-Hansen, A.J.; Wu, H.C.; Cordier, R. 2021
To determine the effects of non-pharmacological randomised controlled trials in adults with autism, a systematic review was conducted across five electronic databases. A total of 3865 abstracts... Show moreTo determine the effects of non-pharmacological randomised controlled trials in adults with autism, a systematic review was conducted across five electronic databases. A total of 3865 abstracts were retrieved, of which 41 articles met all inclusion criteria: randomised controlled trial; non-pharmacological intervention; adults with autism; and English publication. Twenty included studies had strong methodological quality ratings. No meta-analysis could be performed due to heterogeneity between studies. Articles reported on interventions for (1) social functioning and language skills, (2) vocational rehabilitation outcomes, (3) cognitive skills training, and (4) independent living skills. Social functioning was the most studied intervention. PEERS for young adults and Project SEARCH plus ASD support interventions had the strongest evidence. Emerging evidence suggests non-pharmacological interventions could be effective. Show less
Objective To evaluate the development and implementation of clinical practice guidelines for the management of depression globally.Methods We conducted a systematic review of existing guidelines... Show moreObjective To evaluate the development and implementation of clinical practice guidelines for the management of depression globally.Methods We conducted a systematic review of existing guidelines for the management of depression in adults with major depressive or bipolar disorder. For each identified guideline, we assessed compliance with measures of guideline development quality (such as transparency in guideline development processes and funding, multidisciplinary author group composition, systematic review of comparative efficacy research) and implementation (such as quality indicators). We compared guidelines from low- and middle-income countries with those from high-income countries.Findings We identified 82 national and 13 international clinical practice guidelines from 83 countries in 27 languages. Guideline development processes and funding sources were explicitly specified in a smaller proportion of guidelines from low- and middle-income countries (8/29; 28%) relative to high-income countries (35/58; 60%). Fewer guidelines (2/29; 7%) from low- and middle-income countries, relative to high-income countries (22/58; 38%), were authored by a multidisciplinary development group. A systematic review of comparative effectiveness was conducted in 31% (9/29) of low- and middle-income country guidelines versus 71% (41/58) of high-income country guidelines. Only 10% (3/29) of low- and middle-income country and 19% (11/58) of high-income country guidelines described plans to assess quality indicators or recommendation adherence.Conclusion Globally, guideline implementation is inadequately planned, reported and measured. Narrowing disparities in the development and implementation of guidelines in low- and middle-income countries is a priority. Future guidelines should present strategies to implement recommendations and measure feasibility, cost-effectiveness and impact on health outcomes. Show less
y This study investigated speech-language pathologists' (SLPs) perceptions of factors that influence application of a new taxonomy with terminology for describing child language assessment and... Show morey This study investigated speech-language pathologists' (SLPs) perceptions of factors that influence application of a new taxonomy with terminology for describing child language assessment and identified strategies that may facilitate use of taxonomy terminology to collect data on SLP assessment practice. Semi-structured interviews were conducted with 13 SLPs and data were analyzed using thematic analysis. Three main themes were identified in relation to factors that may influence application including applying the taxonomy is arduous, contextual factors may influence application, and SLP experience and knowledge may influence application. Participants identified a number of strategies to facilitate use of taxonomy by SLPs. Findings from this study give insight into the factors that influence SLPs' application of a taxonomy of assessment terms. These findings are important for all SLPs in the child language field to consider if the profession is to be effective in establishing greater consistency in use of professional terminology. Show less
Denman, D.; Kim, J.H.; Munro, N.; Speyer, R.; Cordier, R. 2019
Purpose: Given the barriers that inconsistent terminology poses for the Speech-Language Pathology (SLP) profession, this study aimed to develop an agreed-upon taxonomy with well-defined categories... Show morePurpose: Given the barriers that inconsistent terminology poses for the Speech-Language Pathology (SLP) profession, this study aimed to develop an agreed-upon taxonomy with well-defined categories for describing language assessment practices for children.Method: A taxonomy with illustrative terms for describing assessments across four aspects (modality/domain, purpose, delivery and form) was developed with reference to contemporary literature. In a three round Delphi study, SLPs with expertise in child language were asked to indicate their level of agreement with the taxonomy and provide feedback. Participants were also asked to apply the taxonomy by categorising assessments presented in case studies.Result: A total of 55 participants completed round one, while 43 and 32 completed rounds two and three respectively. Agreed consensus with the taxonomy was achieved in both rounds one and two, with at least 88% of participants agreeing with each aspect and 100% agreeing with the overall structure. In round three, an agreement was reached on 7/10 components for one case study and 4/10 for the other.Conclusion: The development of this taxonomy represents a significant step towards providing detailed terminology for describing language assessments. Future research is needed to investigate implementation strategies to facilitate consistent application of the taxonomy by SLPs. Show less
Speyer, R.; Cordier, R.; Kim, J.H.; Cocks, N.; Michou, E.; Wilkes-Gillan, S. 2019
Aim To determine the prevalence of drooling, swallowing, and feeding problems in persons with cerebral palsy (CP) across the lifespan. Method A systematic review was conducted using five different... Show moreAim To determine the prevalence of drooling, swallowing, and feeding problems in persons with cerebral palsy (CP) across the lifespan. Method A systematic review was conducted using five different databases (AMED, CINAHL, Embase, MEDLINE, and PubMed). The selection process was completed by two independent researchers and the methodological quality of included studies was assessed using the STROBE and AXIS guidelines. Meta-analyses were conducted to determine pooled prevalence estimates of drooling, swallowing, and feeding problems with stratified group analyses by type of assessment and Gross Motor Function Classification System level. Results A total of 42 studies were included. Substantial variations in selected outcome measures and variables were observed, and data on adults were limited. Pooled prevalence estimates determined by meta-analyses were as high as 44.0% (95% confidence interval [CI] 35.6-52.7) for drooling, 50.4% (95% CI 36.0-64.8) for swallowing problems, and 53.5% (95% CI 40.7-65.9) for feeding problems. Group analyses for type of assessments were non-significant; however, more severely impaired functioning in CP was associated with concomitant problems of increased drooling, swallowing, and feeding. Interpretation Drooling, swallowing, and feeding problems are very common in people with CP. Consequently, they experience increased risks of malnutrition and dehydration, aspiration pneumonia, and poor quality of life. What this paper addsDrooling, swallowing, and feeding problems are very common in persons with cerebral palsy (CP). The prevalence of drooling, swallowing, and feeding problems is 44.0%, 50.4%, and 53.5% respectively. There are limited data on the prevalence of drooling, swallowing, and feeding problems in adults. Higher Gross Motor Function Classification System levels are associated with higher prevalence of drooling, swallowing, and feeding problems. There is increased risk for malnutrition, dehydration, aspiration pneumonia, and poor quality of life in CP. Show less
Speyer, R.; Kim, J.H.; Doma, K.; Chen, Y.W.; Denman, D.; Phyland, D.; ... ; Cordier, R. 2019
PurposeThe current review was conducted to identify all self-report questionnaires on functional health status (FHS) and/or health-related quality-of-life (HR-QoL) in adult populations with... Show morePurposeThe current review was conducted to identify all self-report questionnaires on functional health status (FHS) and/or health-related quality-of-life (HR-QoL) in adult populations with dysphonia (voice problems), and to evaluate the psychometric properties of the retrieved questionnaires.MethodsA systematic review was performed in the electronic literature databases PubMed and Embase. The psychometric properties of the questionnaires were determined using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) taxonomy and checklist. Responsiveness was outside the scope of this review and as no agreed gold standard' measures are available in the field of FHS and HR-QoL in dysphonia, criterion validity was not assessed. Only questionnaires developed and published in English were included.ResultsForty-eight studies reported on the psychometric properties of 15 identified questionnaires. As many psychometric data were missing or resulted from biased study designs or statistical analyses, only preliminary conclusions can be drawn. Based on the current available psychometric evidence in the literature, the Voice Handicap Index seems to be the most promising questionnaire, followed by the Vocal Performance Questionnaire.ConclusionsMore research is needed to complete missing data on psychometric properties of existing questionnaires in FHS and/or HR-QoL. Further, when developing new questionnaires, the use of item response theory is preferred above classical testing theory, as well as international consensus-based psychometric definitions and criteria to avoid bias in outcome data on measurement properties. Show less
Speyer, R.; Denman, D.; Wilkes-Gillan, S.; Chen, Y.W.; Bogaardt, H.; Kim, J.H.; ... ; Cordier, R. 2018
Objective: To describe telehealth interventions delivered by allied health professionals and nurses in rural and remote areas, and to compare the effects of telehealth interventions with standard... Show moreObjective: To describe telehealth interventions delivered by allied health professionals and nurses in rural and remote areas, and to compare the effects of telehealth interventions with standard face-to-face interventions.Data sources: CINAHL, Embase, PsycINFO and PubMed databases were searched. The content of relevant journals and published articles were also searched.Study selection: Studies examining the effectiveness of allied health and nursing telehealth interventions for rural and remote populations were included in descriptive analyses. Studies comparing telehealth intervention with standard face-to-face interventions grouped by type of intervention approach were used to examine between-groups effect sizes.Data extraction: Methodological quality of studies was rated using the QualSyst critical appraisal tool and the National Health and Medical Research Council (NHMRC) Evidence Hierarchy levels.Data synthesis: After quality ratings, 43 studies were included. A majority of studies had strong methodological quality. The disciplines of psychology and nursing were represented most frequently, as were studies using a cognitive intervention approach. Meta-analysis results slightly favoured telehealth interventions compared with face-to-face interventions, but did not show significant differences. Interventions using a combined physical and cognitive approach appeared to be more effective.Conclusion: Telehealth services may be as effective as face-to-face interventions, which is encouraging given the potential benefits of telehealth in rural and remote areas with regards to healthcare access and time and cost savings. Show less
As early diagnosis of swallowing and feeding difficulties in infants and children is of utmost importance, there is a need to evaluate the quality of the psychometric properties of pediatric... Show moreAs early diagnosis of swallowing and feeding difficulties in infants and children is of utmost importance, there is a need to evaluate the quality of the psychometric properties of pediatric assessments of swallowing and feeding. A systematic review was performed summarizing the psychometric properties of non-instrumental assessments for swallowing and feeding difficulties in pediatrics; no data were identified for the remaining twelve assessments. The COSMIN taxonomy and checklist were used to evaluate the methodological quality of 23 publications on psychometric properties. For each assessment, an overall quality score for each measurement property was determined. As psychometric data proved incomplete, conflicting or indeterminate for all assessments, only preliminary conclusions could be drawn; the most robust assessment based on current data is the dysphagia disorder survey (DDS). However, further research is needed to provide additional information on all psychometric properties for all assessments. Show less
Kusters, M.; Marijnen, C.A.M.; Velde, C.J.H. van de; Rutten, H.J.T.; Lahaye, M.J.; Kim, J.H.; ... ; Beets, G.L. 2010
Aim of the study: In patients from the Dutch TME trial patterns of local recurrence (LR) in rectal cancer were studied. The purpose was to reconstruct the most likely mechanisms of LR and the... Show moreAim of the study: In patients from the Dutch TME trial patterns of local recurrence (LR) in rectal cancer were studied. The purpose was to reconstruct the most likely mechanisms of LR and the effect of preoperative radiotherapy. Methods: 1417 patients were analyzed; 713 were randomized into preoperative radiotherapy and total mesorectal excision (RT + TME), 704 into TME alone. Of the 114 patients with LR, the subsites of LR were determined and related to tumor and treatment factors. Results: Overall 5-year LR-rate was 4.6% in the RT TME group and 11.0% in the TME group. Presacral local recurrences occurred most in both groups. Radiotherapy reduced anastomotic LR significantly, except when after low anterior resection (LAR) distal margins were less than 5 mm. Abdominoperineal resection (APR) mainly resulted in presacral LR. Even after resection with a negative circumferential resection margin. LR-rates were high. Thirty percent of the patients had advanced tumors, which resulted in 58% of all LRs. Lateral LR comprised 20% of all LR. Presacral and lateral LR resulted in a poor prognosis, in contrast to anterior or anastomotic LRs with a relatively good prognosis. Conclusions: RT reduces LR in all subsites and is especially effective in preventing anastomotic LR after LAR. APR-surgery mainly results in presacral LR, which may be prevented by a wider resection. In the TME trial many advanced tumors were included, rather requiring chemoradiotherapy instead of RT. Currently, with good imaging techniques, better selection can take place. Especially lateral LR might be a problem in the future. (C) 2009 Elsevier Ltd. All rights reserved. Show less
Kusters, M.; Marijnen, C.A.M.; Velde, C.J.H. van de; Rutten, H.J.T.; Lahaye, M.J.; Kim, J.H.; ... ; Beets, G.L. 2010
AIM OF THE STUDY: In patients from the Dutch TME trial patterns of local recurrence (LR) in rectal cancer were studied. The purpose was to reconstruct the most likely mechanisms of LR and the... Show moreAIM OF THE STUDY: In patients from the Dutch TME trial patterns of local recurrence (LR) in rectal cancer were studied. The purpose was to reconstruct the most likely mechanisms of LR and the effect of preoperative radiotherapy. METHODS: 1417 patients were analyzed; 713 were randomized into preoperative radiotherapy and total mesorectal excision (RT + TME), 704 into TME alone. Of the 114 patients with LR, the subsites of LR were determined and related to tumor and treatment factors. RESULTS: Overall 5-year LR-rate was 4.6% in the RT + TME group and 11.0% in the TME group. Presacral local recurrences occurred most in both groups. Radiotherapy reduced anastomotic LR significantly, except when after low anterior resection (LAR) distal margins were less than 5 mm. Abdominoperineal resection (APR) mainly resulted in presacral LR. Even after resection with a negative circumferential resection margin, LR-rates were high. Thirty percent of the patients had advanced tumors, which resulted in 58% of all LRs. Lateral LR comprised 20% of all LR. Presacral and lateral LR resulted in a poor prognosis, in contrast to anterior or anastomotic LRs with a relatively good prognosis. CONCLUSIONS: RT reduces LR in all subsites and is especially effective in preventing anastomotic LR after LAR. APR-surgery mainly results in presacral LR, which may be prevented by a wider resection. In the TME trial many advanced tumors were included, rather requiring chemoradiotherapy instead of RT. Currently, with good imaging techniques, better selection can take place. Especially lateral LR might be a problem in the future. Show less
