Speech Language Pathology

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Background: This study aimed to introduce a low-cost system measuring nasalance, which can often be performed with high-cost systems, and to present the normative nasalance values for adults using this system.
Materials and Methods: This study included 96 standard native Turkish-speaking literate volunteers who had no hearing and speech problems or nasal obstruction. Nasalance values were measured using the system developed by the principal author, which is called the Praat-Assisted Nasalance Meter, using speech materials and related methods.
Results: The participants were 18-65 (average, 33.7) years old. They were divided into three groups according to their age: 18-25, 26-40, and 41-65. A significant difference was found in the nasalance values between the genders. For nearly all speech materials, higher nasalance values were measured in women than in men.
Conclusion: There is no generally accepted rule to ascertain if a speaker’s resonance is abnormal according to nasalance values. Therefore, the proposed threshold values should not be considered absolute values but should be decided with perceptual evaluation.

Amaç: Bu çalışmanın amacı, genellikle yüksek maliyetli sistemlerle gerçekleştirilebilen nazalans parametresi ölçümü için kullanılabilecek kendi geliştirdiğimiz düşük maliyetli bir sistemi tanıtmak ve bu sistem kullanılarak erişkinler için belirlenen normatif nazalans değerlerini sunmaktır.
Gereç ve Yöntemler: Standart Türkiye Türkçesi konuşan ve okuma yazma bilen 96 gönüllü çalışmaya dahil edildi. Deneklerin işitme ve konuşma problemi, burun tıkanıklığı yapan herhangi bir hastalığının olmamasına dikkat edildi. Birinci yazar tarafından geliştirilen ve Praat Yardımlı Nazalans Ölçer (PYNÖ) adı verilen sistem yardımıyla aşağıda belirtilen konuşma malzemesi ve yöntem kullanılarak nazalans ölçümü yapıldı.
Bulgular: Çalışmaya katılan 96 konuşmacının yaşları 18 ile 65 arasında değişiyordu (ortalama 33,7 yıl). Katılımcılar yaşlarına göre 18-25, 26-40 ve 41-65 şeklinde üç gruba ayrılarak incelendi. Elde edilen değerler cinsiyet grubuna göre karşılaştırıldığında aradaki farkların istatistiksel olarak anlamlı olduğu görüldü. Hemen her konuşma malzemesi için kadınlarda erkeklerden daha yüksek nazalans değerleri elde edildi.
Sonuç: Bir konuşmacı üzerinde ölçülen nazalans ölçüm sonuçlarının anormal olduğunu söylemek için genel kabul gören bir kural yoktur. Bu nedenle, bu çalışmada önerilen eşik değerler mutlak değerler olarak düşünülmemeli, algısal değerlendirmeyle birlikte karar verilmelidir.

TemPO (TEMporalité, Pathologie orthophonique, Ontologie) is an attempt to transform a draft conceptual model created for the French orthophonie/speech and language therapy (SLT) community into an ontological resource focusing on language and communication pathology. It is interdisciplinary (SLT, linguistics, terminology and descriptive logic) and focuses on temporality as an entry point. It is part of a 3 step project aiming at harmonising European SLT terminology in order to facilitate communication about language pathology. The first step was to extract some characteristics using semantic and syntactic analyses, the second one is the creation and validation of the ontology (TemPO) and it will be followed by a larger multilingual terminological project at a European level.

Purpose: The importance of coordination of educational services has been well documented in the literature. For students with disabilities, coordinated programs result in more rapid acquisition of targeted behaviors and the increased likelihood of long-term maintenance of gains. The purpose of this study was to assess whether "priming" or exposing students with autism and disruptive behaviors to school assignments before their presentation in class would affect academic performance and problem behaviors. Method: Two students diagnosed with autism who attended general education classrooms, both of whom exhibited numerous disruptive behaviors and low academic performance, participated in this study. A repeated reversals design was used to monitor student progress. Results: The results demonstrated decreases in problem behavior and increases in academic responding when priming sessions occurred. Clinical Implications: Application is discussed in terms of a mechanism for speec...

Purpose: The Australian English Communicative Development Inventory (OZI) is a 558-item parent report tool for assessing language development at 12-30 months. Here, we introduce the short form (OZI-SF), a 100-item, picture-supported, online instrument with substantially lower time and literacy demands. Method: In tool development (Study 1), 95 items were drawn from the OZI to match its item distribution by age of acquisition and semantic categories. Five items were added from four other semantic categories, plus 12 gestures and six games/routines. Simulations computed OZI-SF scores from existing long-form OZI norm data, and OZI and projected OZI-SF scores were correlated. In an independent norming sample (Study 2), parents (n ¼ 230) completed the OZI-SF for their children aged 12-30 months. Child scores were analysed by age and sex. Result: OZI-SF and OZI scores correlate highly across age and language development levels. Vocabulary scores (receptive, expressive) correlate with age and the median for girls is higher until 24 months. By 24 months, 50% of the sample combine words "often". The median time to OZI-SF completion was 12 minutes. Conclusion: Fitted percentiles permit working guidelines for typical (median) performance and lower cutoffs for children who may be behind on age-based expectations and/or at risk for a communication difficulty. The OZI-SF is a short-form of the OZI that has promise for research and clinical/educational use with Australian families.

Purpose: Aphasia has a negative impact on a person's quality of life (QOL). The Stroke Aphasia Quality of Life-39 scale (SAQOL-39) is a widely-used measure of health-related quality of life (HRQOL) developed for people with aphasia that has been translated into several languages. Its psychometric properties have been examined not only in English, but also in other languages. This study examined the reliability and validity of a translation and adaptation of the SAQOL-39 into Serbian in Serbian-speaking people with aphasia. Method: Using forward and backward translation, the SAQOL-39 was translated and adapted from English into Serbian and its psychometric properties were examined in 90 Serbian-speaking people with a broad range of times post-onset of aphasia. Internal consistency, test-retest reliability and other analyses were conducted. Result: Internal consistency and test-retest reliability of the Serbian version was high (Cronbach's a > 0.9; ICC !0.87), which is similar to versions of the scale in other languages. Conclusion: The Serbian translation and adaptation of the SAQOL-39 was shown to be a valid and reliable measure of QOL in people with aphasia with reliable psychometric properties and is suitable for the assessment of Serbian people with aphasia.

The technique of fiberoptic endoscopic evaluation of swallowing disorders (FEES), and a comparison of its utility with that of videofluoroscopic examination in patients with dysphagia, was presented in a workshop session. Viewpoints were expressed by two speech pathologists and an otolaryngologist experienced in assessment and treatment of patients with dysphagia, and representative cases, illustrated with videotaped FEES and videofluoroscopic studies, were discussed. Some of the major advantages and disadvantages of each of these modalities are discussed in the following three articles.

Communication dysfunction that results from dementia can be exacerbated by environmental barriers such as inadequate lighting, noisy conditions, poor or absent environmental cues, and visual clutter. Speech-language pathologists (SLPs) should address these environmental barriers as part of a comprehensive treatment plan for clients with dementia. The Environment and Communication Assessment Toolkit for Dementia Care (ECAT) was evaluated by SLPs to determine: (1) changes in awareness of environmental factors prior to and after training; (2) impact of the ECAT on practice as measured by changes in the number of environmental modifications recommended and made prior to and after training; (3) utility of the information as measured by the helpfulness, amount of new information, and usefulness of the ECAT; and (4) usability of the ECAT materials based on ease of use. The SLPs used the ECAT with clients with dementia who had functional limitations and required substantial assistance with daily activities. Results indicate that the ECAT is an effective tool for SLPs, providing information about the impact of the environment on communication and supplying sufficient resources to make recommendations and implement effective interventions. The ECAT successfully increased awareness of environmental modifications, influenced the practice of recommending environmental modifications, and had utility in diverse aspects of clinical practice.

Background Educational computer games are examples of computer-assisted learning objects, representing an educational strategy of growing interest. Given the changes in the digital world over the last decades, students of the current generation expect technology to be used in advancing their learning requiring a need to change traditional passive learning methodologies to an active multisensory experimental learning methodology. The objective of this study was to compare a computer game-based learning method with a traditional learning method, regarding learning gains and knowledge retention, as means of teaching head and neck Anatomy and Physiology to Speech-Language and Hearing pathology undergraduate students. Methods Students were randomized to participate to one of the learning methods and the data analyst was blinded to which method of learning the students had received. Students’ prior knowledge (i.e. before undergoing the learning method), short-term knowledge retention and ...

Purpose To determine what research evidence exists to support the use of voice measures in the clinical assessment of patients with voice disorders. Method The American Speech-Language-Hearing Association (ASHA) National Center for Evidence-Based Practice in Communication Disorders staff searched 29 databases for peer-reviewed English-language articles between January 1930 and April 2009 that included key words pertaining to objective and subjective voice measures, voice disorders, and diagnostic accuracy. The identified articles were systematically assessed by an ASHA-appointed committee employing a modification of the critical appraisal of diagnostic evidence rating system. Results One hundred articles met the search criteria. The majority of studies investigated acoustic measures (60%) and focused on how well a test method identified the presence or absence of a voice disorder (78%). Only 17 of the 100 articles were judged to contain adequate evidence for the measures studied to ...

This paper ®rst explores evidence that speech±language pathologists are experiencing dissatisfaction with their roles and then argues that one source of dissatisfaction may be in a mismatch between personal and organisational values. In order to clarify their notion of values, the authors next present a model that outlines various levels at which values operate in therapy and show how values pervade all aspects of practice. The paper then offers some practical examples of how a new organisation has tried to address overtly the implementation of values in practice, with suggestions for how other practitioners might go about making their own personal and organisational values more explicit. The paper ends with a few caveats about the dif®culties and dangers of attending to values and conclude with why it is a bene®cial endeavour. Learning outcomes: Participants will be able to (1) understand issues and practices that contribute to professional burnout; (2) describe a values-based framework for clinical practice; (3) understand the importance of concerning oneself with values, despite the dif®culties in so doing; (4) explore some dif®culties in adopting a medical model. #

Most contemporary text books of neurology and of psychology pay little attention to the function of the cerebellum beyond noting it to be an organ of motor control. A historical overview of research on cerebellar function is presented, from pre-Sherrinton suggestions of sensory and motor function, through the post-Sherrinton and dominant 20 th . Century view of "motor" function, to the 21 st . century perspective of "sensorimotor" function. The intrinsic capability of the cerebellum is briefly considered in terms of: its size/complexity/capacity; its information representation/processing characteristics (with "a particular computational function"); its sensory information processing capability; and, its role in sensorimotor regulatory control. It is suggested that the cerebellum can process sensorimotor stimulus information in a statistical (connectionist type) manner and respond to in on the basis of its own learning based sensorimotor representations, albeit at a "level" that does not necessarily involve cerebral "awareness".

The role of the speech-language pathologist (SLP) has developed considerably over the past 20 years given the medical and technological advances in life-sustaining procedures. Children born with congenital, surgical, or "medically fragile" conditions become mainstreamed into regular school-based settings, thus extending the traditional role of the treating SLP and multidisciplinary team. Understanding the impact of associated voice disorders on educational performance requires dissemination of additional and important information, as eligibility decisions for students in school-based settings must be made within the framework of the federal legislation and regulations governing the provision of services for students with disabilities. This article discusses how to identify children with voice disorders under the Individuals with Disabilities Education Improvement Act (IDEA), the role of the SLP in various triaging scenarios, and how models of voice therapy can be integrated in a school-based setting.

Purpose: To describe the instructional strategies reported for multicultural /multilingual issues (MMI) education at programs in speech-language pathology and audiology and the perceived ease and effectiveness of doing so. Method: A 49-item questionnaire elicited anonymous responses from administrators, faculty, and teaching clinical supervisors at educational programs accredited by the American Speech-Language-Hearing Association in the United States. The data were provided by 731 respondents from 79.6% of 231 accredited U.S. programs. They included instructors who taught courses dedicated to MMI and those who did not. Results: Respondents were generally committed to multicultural instruction, but they varied in their reported instructional practices and perceived levels of preparedness, effectiveness, and needs. General curricular infusion without an MMI-dedicated course was the most common instructional model used. Students were judged to be at least modestly prepared to deal with diversity issues as a result of their multicultural instruction, although current instructional approaches were not viewed as optimal. More positive outcomes were reported by instructors of MMI-dedicated than MMI-nondedicated courses. Conclusion: The instructional models and strategies used for MMI education vary, and programs are challenged by multiple issues in complying with the mandate for MMI curricular infusion.

Education of health professionals is costly to the general community and more specifically the educational sector. The increasing need for speech and language therapy (SLT) services, coupled with poor employment retention rates, poses serious cost-benefit considerations. The poor job retention rates among speech and language therapists are associated with high levels of job dissatisfaction. One factor known to influence job satisfaction is the congruence between one's career motivation and actual career experience. The current study sought to explore (1) why students choose to embark on an SLT degree, (2) what factors are important to maintain their long-term employment in SLT, and (3) how long they predicted they would remain in the workforce practicing in SLT. Students from two tertiary SLT courses, one in Australia (n=67) and one in the United Kingdom (n=84), completed an online questionnaire targeting these issues. Students' responses were consistent across cohorts, so t...

This study investigates a comprehensive assessment of language disorders in order to identify impaired and unaffected language abilities of individuals with schizophrenia. Furthermore, the purpose of this study was to demonstrate the importance of the role of speech therapists in the treatment of schizophrenia. Speech therapy is especially thought to treat language disorders. However, to date, speech therapists have not been solicited in the treatment of schizophrenia, despite growing evidence supporting that schizophrenia is characterized by cognitive disorders such as impairments in memory, attention, executive functioning and language. In this article, we discuss the fact that elements of language and cognition are interactively affected and that cognition influences language. We then demonstrate that language impairments can be treated in the same way as neurological language impairments (cerebrovascular disease, brain injury), in order to reduce their functional outcome. Schizophrenia affects the pragmatic component of language with a major negative outcome in daily living skills [Champagne M, Stip E, Joanette Y. Social cognition deficit in schizophrenia: accounting for pragmatic deficits in communication abilities ? Curr Psychiatry Rev:2006;(2):309-315]. The results of our comprehensive assessment also provide a basis for the design of a care plan. For this, subjects with schizophrenia were examined for language comprehension and language production with a focus on pragmatic abilities. In neurology, standardized tests are available that have been designed specifically to assess language functions. However, no such tests are available in psychiatry, so we gathered assessments widely used in neurology and examined the more relevant skills. In this article, each test we chose is described and particular attention is paid to the information they provided on impaired language abilities in schizophrenia. In this manner, we provide an accurate characterization of schizophrenia-associated language impairments and offer a solid foundation for rehabilitation. Current research makes connections between schizophrenia and other neurological disorders concerning language. Nevertheless, further studies are needed to explore these connections to complete our investigations. The strategies we designed are aimed at enabling a subject with schizophrenia to improve his/her language skills. We support the idea that such improvement could be reached by speech therapy. We conclude that speech therapists can play an important role in the non pharmacological treatment of schizophrenia, by selecting appropriate interventions that capitalize on spared abilities to compensate for impaired abilities.

Background: Feeding and or swallowing problems tend to persist in adolescents with CP Objective: To assess feeding and swallowing problems in the physical, functional and emotional domains in adolescents with CP using Feeding Handicap Index (FHI), a tool developed in the Indian context, and to compare the results obtained through FHI with other dysphagia assessment tools. Methods: Cross sectional study was conducted with a random sample of 15 participants in the age range of 13 to 17.11 years. FHI was administered on the participants to assess the physical, functional and emotional domains of feeding. The functioning of oral structures during feeding was assessed through BASOFF. The different levels and severity of feeding impairments were classified through Eating and drinking ability classification system (EDACS) and Dysphagia outcome and severity Scale respectively (DOSS). Descriptive statistics was done and Spearman correlation was used to find the relationship between FHI and other dysphagia assessment tools. Results: Administration of FHI on adolescents with CP revealed that they exhibited feeding and swallowing problems in different domains. FHI had high correlation with other western feeding assessment tools. Conclusions: Hence FHI is an effective subjective feeding assessment tool to assess various domains of feeding in adolescents.
What this paper adds on:
Documents the feeding and swallowing problems in adolescents with CP
Tool to assess feeding and swallowing in the physical, functional and emotional domains in adolescents with CP
Efficacy of the tool in identifying feeding and swallowing problems in adolescents with CP

Vocal hygiene program is a behavioral approach to treat voice disorders. It focuses on various vocal and non-vocal habits which, by following appropriately would reduce the symptoms of the voice disorder and also prevent developing a voice disorder. Information Technology Enabled Service (ITES) professionals are inclined to use their voice extensively to earn their living. Hence, this study focuses on developing a vocal hygiene program exclusively for voice users belonging to Information Technology Enabled Services. The results were compared using Voice Handicap Index, Vocal Fatigue Index before and after the implementation of vocal hygiene program on 31 professional voice users belonging to ITES which showed the improvements achieved were statistically significant. Hence, Vocal hygiene program for ITES professionals is a necessity and shall yield reliable realistic improvements.

A questionnaire investigating the levels of interest in and knowledge of vocal function and dysfunction was completed by 129 singers. Those with professional singing experience indicated significantly greater interest and higher perceived knowledge levels than amateurs in areas of vocal anatomy and physiology, vocal hygiene, and functional vocal pathologies. Greater interest levels, but not higher perceived knowledge levels were reported by professional singers (PSs) in the area of the role of the speech-language pathologist (SLP) and the voice. Professionals answered significantly more knowledge-based questions correctly than amateurs in all areas except the role of the SLP and the voice. However, findings indicated wide variability in knowledge levels of both groups. Singing teachers (STs) within the group significantly outperformed the remainder of the group in areas of vocal anatomy and physiology, vocal hygiene, and functional vocal pathologies. Scores of the choir directors (CDs) within the group were not significantly superior to the remainder of the group except in the area of functional vocal pathologies. Implications for a preventative approach to vocal health are discussed.

The ending of therapy is a crucial time for speech-language pathologists and can impact on their sense of achievement and satisfaction. Drawing on literature from psychotherapy, social work and rehabilitation as well as from the area of aphasia therapy, this paper explores how speech-language pathologists juggle the tensions of coping with real versus ideal endings, of managing the building of close therapeutic relationships which then have to be broken, and of balancing a respect for client autonomy while retaining control over caseloads and fair allocation of resources. I suggest that the way in which therapy finishes reflects a merger of how clinicians manage these tensions. Clinicians may benefit from a greater recognition of what they do and feel at discharge, not only to further reflective practice, but also to encourage more sensitive involvement with both clients and students.

Objectives The paper presents a research study investigating the effectiveness and acceptability of community speech and language therapy provision for preschool children with early speech/ language delays. As a 'worked example' , it demonstrates the value of a multimethod approach to evaluation. Methods The paper examines how the research findings of a pragmatic randomized controlled trial (RCT), a survey questionnaire and qualitative in-depth interviews, which were the methods used in the evaluation, overlap and complement each other. Results There was little evidence to establish the effectiveness of the speech and language therapy provided in the trial. This lack of difference was reflected in responses of parents to items on the questionnaire. The findings of the RCT, questionnaire and interviews all cast considerable doubt on the prospect of spontaneous resolution of the children's difficulties. Although the RCT showed few differences between the children allocated to immediate therapy or 'watchful waiting' , the questionnaire and interviews revealed the circumstances in which the parents felt that these intervention strategies had been acceptable and unacceptable. Conclusions Although the trial provided information about the progress of the children, the questionnaire and interview components highlighted the advantages and limitations of the intervention from the viewpoint of parents, thereby helping to explain the RCT findings. Thus, the study demonstrates how a multimethod approach to evaluation can yield useful information to explain the findings of RCTs.

This study aimed to gather information from school-and clinic-based professionals about their practices and opinions pertaining to the provision of bilingual supports to students with developmental disabilities. Using an online survey, data were collected in six socio-culturally and linguistically diverse locations across four countries: the United States, Canada, the United Kingdom, and the Netherlands. In total, 361 surveys were included in the analysis from respondents who were primarily teachers and speech-language pathologists working in schools, daycares/preschools, or community-based clinics. The overall picture that emerged from the data reflected a disconnection between practice and opinion. In general, respondents believed that children with both mild and severe disabilities are capable of learning a second language, although their opinions were more neutral for the latter group. However, children with both mild and severe disabilities who spoke only a minority language at home had less access to services for second language learners than did their typically developing peers, although respondents agreed that such services should be more available. Regardless of clinical group, children who lived in homes where a minority language was spoken were often exposed to, assessed in, and treated in the majority language only; again, respondents generally disagreed with these practices. Finally, second language classes were less available to children in the two disability groups compared to typically developing bilingual children, with general agreement that the opportunity to acquire a second language should be more available, especially to those with mild disabilities. Although the results indicate that there is a considerable gap between current practices and professional opinions, professionals appear to be more supportive of bilingual educational opportunities for these populations than was suggested by previous research.

Purpose: The Australian English Communicative Development Inventory (OZI) is a 558-item parent report tool for assessing language development at 12-30 months. Here, we introduce the short form (OZI-SF), a 100-item, picture-supported, online instrument with substantially lower time and literacy demands. Method: In tool development (Study 1), 95 items were drawn from the OZI to match its item distribution by age of acquisition and semantic categories. Five items were added from four other semantic categories, plus 12 gestures and six games/routines. Simulations computed OZI-SF scores from existing long-form OZI norm data, and OZI and projected OZI-SF scores were correlated. In an independent norming sample (Study 2), parents (n ¼ 230) completed the OZI-SF for their children aged 12-30 months. Child scores were analysed by age and sex. Result: OZI-SF and OZI scores correlate highly across age and language development levels. Vocabulary scores (receptive, expressive) correlate with age and the median for girls is higher until 24 months. By 24 months, 50% of the sample combine words "often". The median time to OZI-SF completion was 12 minutes. Conclusion: Fitted percentiles permit working guidelines for typical (median) performance and lower cutoffs for children who may be behind on age-based expectations and/or at risk for a communication difficulty. The OZI-SF is a short-form of the OZI that has promise for research and clinical/educational use with Australian families.

For children to progress in their use of augmentative communication systems, in-service training of staff in schools is required. This paper presents preliminary evaluation of a training package entitled 'My Turn to Speak'. Nineteen participants and 10 comparison staff were filmed before and after a five-session training workshop, interacting in the classroom in naturally occurring situtations with a non-speaking physically disabled child. Significant improvements in the quality of adults' facilitation of the children's communication was dircernible at follow-up, four months aper completion of the training. However, teachers were found to alter their behaviour more quickly after training than non-teaching staff-The requirements for setting up successful multidisciplinary training are discussed.

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The role of the speech-language pathologist (SLP) has developed considerably over the last 10 years given the medical and technological advances in life-sustaining procedures. Over time, children born with congenital, surgical, or "medically fragile" conditions have become mainstreamed into regular school-based settings, thus extending the traditional role of the SLP and multidisciplinary team. Understanding the impact of these voice disorders on the child’s educational performance has been a struggle for many clinicians because the eligibility decisions for students in school-based settings must be made within the framework of federal legislation and regulations governing the provision of services for students with disabilities. This article discusses how to identify children with voice disorders under the Individuals With Disabilities Education Act (IDEA) definition, the role of the SLP in assigning priority in various voice management scenarios, and how models of therap...

Despite the importance of Speech-Language Pathologists (SLPs) collaborating with parents in the treatment of children with Autism Spectrum Disorder (ASD), few studies have examined the nature of this working relationship and how best to facilitate collaboration. To explore what SLPs think parents of children with ASD expect of them when it comes to the delivery of evidence-based interventions. The participants were 22 SLPs from Australia who specialised in ASD and who each participated in a semi-structured interview. Recordings were transcribed and analysed according to the procedures outlined by Braun and Clarke. The SLPs expressed strong support for evidence-based practice (EBP) and indicated that they thought parents expected their children would be provided with evidence-based interventions. However, SLPs identified factors that influenced the way and the extent to which they were able to share information as part of a collaborative decision-making process, including the parents...

This study provides a systematic description of French consonant acquisition in a large cohort of preschool aged children: 156 children aged 20-53 months participated in a picture-naming task. Five analyses were conducted to study consonant acquisition: (1) consonant inventory, (2) consonant accuracy, (3) consonant acquisition, (4) a comparison of consonant inventory to consonant acquisition, and (5) a comparison to English cross-sectional data. Results revealed that more consonants emerge at an earlier age in word initial position, followed by medial position, and then word final position. Consonant accuracy underwent the greatest changes before the age of 36 months, and achieved a relative plateau towards 42 months. The acquisition of consonants revealed that four early consonants were acquired before the age of 36 months (i.e., /t, m, n, z/); 12 intermediate consonants were acquired between 36 and 53 months (i.e., /

Purpose: The aim of this tutorial is to support speech-language pathologists (SLPs) undertaking assessments of multilingual children with suspected speech sound disorders, particularly children who speak languages that are not shared with their SLP. Method: The tutorial was written by the International Expert Panel on Multilingual Children’s Speech, which comprises 46 researchers (SLPs, linguists, phoneticians, and speech scientists) who have worked in 43 countries and used 27 languages in professional practice. Seventeen panel members met for a 1-day workshop to identify key points for inclusion in the tutorial, 26 panel members contributed to writing this tutorial, and 34 members contributed to revising this tutorial online (some members contributed to more than 1 task). Results: This tutorial draws on international research evidence and professional expertise to provide a comprehensive overview of working with multilingual children with suspected speech sound disorders. This over...

Purpose: The aim was to investigate, describe and analyse speech characteristics, intelligibility, orofacial function and coexisting neurodevelopmental symptoms in children with SSD of unknown origin, persisting after six years of age. Method: The study included 61 children with SSD (6-17 years) of unknown origin, referred for a speech and oral motor examination. The severity of SSD was estimated using Percentage Consonants Correct (PCC) and Percentage Vowels Correct (PVC) and assessments of resonance based on Swedish Articulation and Nasality Test (SVANTE). Orofacial function was screened using the Nordic Orofacial Test-Screening (NOT-S). Parents completed the Intelligibility in Context Scale (ICS) and a questionnaire including questions about heredity, medical and neurodevelopmental conditions, and speech development. Result: SSD varied according to PCC (8-95%) and PVC (55-100%) measurements. Percentages of co-occurring disorders included: 51% resonance deviations, 90% intelligibility issues, and 87% orofacial difficulties. The most affected orofacial domains were "Chewing and swallowing" (41%), "Masticatory muscles and jaw function" (38%) and "Sensory function" (38%). The majority (64%) had co-existing dysfunctions relating to general motor and neurodevelopmental disorders. Conclusion: Children with persistent SSD are at risk for orofacial dysfunction, general motor difficulties and other neurodevelopmental disorders and therefore should be screened for co-occurring disorders.

Like other areas of speech-language pathology, the behavioural management of voice disorders lacks precision regarding optimal dose -response relationships. In voice therapy, dosing can presumably vary from no measurable effect (i.e., no observable benefi t or adverse effect), to ideal dose (maximum benefi t with no adverse effects), to doses that produce toxic or harmful effects on voice production. Practicing specifi c vocal exercises will inevitably increase vocal load. At ideal doses, these exercises may be non-toxic and benefi cial, while at intermediate or high doses, the same exercises may actually be toxic or damaging to vocal fold tissues. In pharmacology, toxicity is a critical concept, yet it is rarely considered in voice therapy, with little known regarding " effective " concentrations of specifi c voice therapies vs " toxic " concentrations. The potential for vocal fold tissue damage related to overdosing on specifi c vocal exercises has been under-studied. In this commentary, the issue of dosing will be explored within the context of voice therapy, with particular emphasis placed on possible " overdosing " .

Objectives: This study aimed to explore satisfaction and competency with telepractice services among Speech-Language Pathologists (SLPs) in Pakistan. Methods: This cross-sectional study with a sample of 204 SLPs was conducted at Riphah International University, Lahore Campus, Lahore, Pakistan, from August 2020 to December 2020. Our study recruited qualified SLPs of both genders, aged between 25 and 60 years, using a convenience sampling technique. Non-practicing SLPs and those holding administrative posts were excluded from this study. The “Service Provider Questionnaire for Telepractice” was used for data collection. The obtained data were analyzed in SPSS v. 22. The Chi-square and Pearson r correlation were used to detect any relationships between study variables, and P<0.05 was significant. Results: The results showed that SLPs are pretty satisfied with using telepractice and building relationships with child/family, compared to face-to-face practice, and did not reveal signif...

Learners in South African schools have been found to perform poorly in mathematics because they do not understand the language used in solving mathematical problems. In order to improve academic performance teachers need to be made aware of the importance of language in the development of numeracy. A continued professional development (CPD) programme addressed this need. The purpose of the research was to understand how the participants implemented the strategies developed during the programme and how they perceived the support provided by the programme. The research was conducted over 2 years in semi-rural and urban contexts. As part of a more comprehensive mixed method study, the qualitative data referred to in this article were obtained through open-ended questions in questionnaires, focus groups, reflections in portfolios, and a research diary. Results showed that numeracy terminology was often used by learners that differed from standard terminology prescribed by the curriculum. The participants themselves did not necessarily understand the numeracy terminology and thus found it a challenge to implement curriculum outcomes. Issues related to language use of the participants in teaching numeracy were associated with the lack of resources available in the language of learning and teaching (LoLT). Some of the participants taught numeracy in English, rather than LoLT. The results indicated low teacher expectations of the learners. The CPD programme was considered valuable and effective. SLPs in schools need to be expand their role to provide CPD opportunities for teachers.

Aphasia is a chronic communication disability and the communication, information and psychosocial support needs of individuals and families impacted by aphasia change across time (Hilton et al., 2014; Lyon & Shadden, 2001). This is particularly so following discharge from formal inpatient and outpatient rehabilitation services, when with a newly acquired chronic communication disability, PWA face the large challenge of readjustment to work, family and community life (Howe,

BACKGROUND:
In spite of its indusrial usefulness and varied daily uses, lead (Pb) pollution is a widespread ecological problem that faces the humans in the 21th century. Pb was found to produces a wide range of toxic effects including neurotoxicity especially to the developing and young offspring. Recently, the utilization of herbal plants has received a significant attention where there has been rising awareness in their therapeutic use; among these is the garlic.
AIM OF THE WORK:
In light of the above, the current study is designed experimentally in female pregnant rats in order to investigate the beneficial role of garlic extract in the protection from the maternal and fetal cerebellar damage that produced by administration of different doses of Pb during pregnancy.
MATERIALS AND METHODS:
Positively pregnant female rats were divided into five groups; one control group, two Pb-treated groups (exposed to 160 and 320 mg/kg b.wt. of Pb, respectively) and two groups treated with both Pb and garlic (exposed to Pb as previous groups together with 250 mg/ kg b.wt. /day of garlic extract). Treatments started from day 1 till day 20 of pregnancy, where the mother rats of different experimental groups were sacrified to obtain the fetuses. Pb level in the maternal nd fetal blood and cerebellum was estimated by spectrophotometry. Specimens of the cerebellum of different mother and fetal groups were processed to histological and immunohistochemical staining for microscopic examination.
RESULTS:
The results showed that administration of Pb to pregnant rats resulted in a dose-dependent toxicity for both mothers and fetuses in the form of decrease of maternal weight gain, placental and fetal weights, brain weight and diminished fetal growth parameters, which were prominent in rat's group treated with larger dose of Pb. In Pb-treated rats, Pb level in blood and cerebellum was high when compared to the control. The histopathological examination of the cerebellum of treated dams and fetuses showed marked alterations mainly in the form of Purkinje cell degeneration and lack of deveopmet of fetal cerebellum. Co-treatment of garlic extract along with Pb resulted in a significant decrease in Pb levels as compared with those treated with Pb alone with improvement of the histopathological changes.
CONCLUSIONS:
This study was useful in evaluating the hazardous effects of uncontrolled use of Pb in general and in assessing the developmental and neurotoxicity of fetuses due to exposure during pregnancy in particular. Co-administration of garlic has beneficial effects in amelioration of Pb-induced neurotoxicity and reversing the histopathological changes of the cerebellum of mother rats and fetuses.
KEYWORDS:
garlic; glial fibrillary acidic protein; lead; purkinje cells

This paper is the final response in a scientific forum examining the impact of ending therapy on speech-language pathologists. The lead paper explored how speech-language pathologists juggle the tensions of coping with real versus ideal endings, of managing the building of close therapeutic relationships which then have to be broken, and of balancing a respect for client autonomy while retaining control over caseloads and fair allocation of resources. The nine respondents in this scientific forum, representing a range of clinical, research, cultural and geographical contexts, have highlighted their concerns, insights and suggestions in relation to discharge practice. In this closing section, I suggest that this scientific forum has the potential to act as a catalyst towards positive change. My reasons for this are threefold, relating to raising awareness, acknowledging the personal impact, and developing or promoting strategies for successful discharge experiences.

More than 2 million people in the United States are unable to speak or use handwriting as an effective and efficient mean of communication (ASHA,2004). This paper discusses a brief history of augmentative alternative communication (AAC) devices. The ultimate goal of an AAC intervention is to enable individuals to efficiently and effectively engage in a variety of interactions. Communication is a critical element of staying connected to society and is the tool for redefining one’s self. This paper discusses the history of AAC, as well as etiologies that may benefit from AAC use. Without access to speech, individuals are severely restricted within communication and participation in all aspects of life. Furthermore, new mobile technology such as the iPad has brought AAC into the mainstream. The iPad and other mobile technologies provide powerful new tools to potentially enhance communication for individuals with developmental disabilities, acquired neurogenic disorders, and degenerative neurological conditions. A brief comparison between today's mobile technologies and traditional AAC devices such as the Picture Exchange Communication System (PECS) and the Voice Output Communication Device (VOCD) proves which speech generating device (SGD) is more beneficial to individuals that require AAC.


Keywords: Augmentative alternative communication; Picture Exchange Communication System; Voice Output Communication; Speech Generating Device; iPad; Mobile technology