Building a typical and disordered speech dataset for teaching and assessing phonetic transcription in speech and language therapy students in Ireland

Telehealth placements in speech and language therapy provide crucial opportunities for both learning and service delivery when clinicians, students and/or clients are separated by factors such as distance or illness. While the use of telehealth placements has increased in recent times, they remain a relatively underexplored phenomenon with limited information available about the perceptions and experiences of practice educators and students. The aim of this study was to explore experiences of telehealth-delivered speech and language therapy services and tele-supervision from the perspective of speech and language therapy students and practice educators. This study used a sequential exploratory mixed methods design with a questionnaire study followed by a series of focus groups with Australian speech and language therapy educators and speech pathology students. Different questionnaires were used with students (n=56) and practice educators (n=27); each explored perceptions of interaction, engagement and student learning via multiple-choice and open-ended questions. Multiple-choice answers were analysed descriptively; open-ended questions were analysed with qualitative content analysis. The results informed the focus group questions. Separate focus groups were held with students (n=17) and practice educators (n=20); each explored student learning and development as well as educator supervisory practices. Data were analysed inductively using thematic network analysis. Responses from both student and practice educator questionnaires indicated that students develop some different skills on telehealth placements compared to in-person placements and telehealth placements were more suitable for some students compared to others. We constructed 12 basic themes related to student and educator practices, student learning, client care, perceptions about telehealth, and location of educator and student. These were grouped into three organising themes: processes, perceptions, place. The organising themes were summarised into the overarching theme 'telehealth and in-person placements: same, same, but different'. This study adds to the growing body of literature indicating that telehealth placements can meet student learning needs. It suggests that both educators and students need to learn new skills or adapt their current practices to engage in these placements. This paper includes recommendations for how to manage the different practices required by universities, educators and students to promote successful telehealth placements, particularly when the educator and student are not co-located. What is already known on this subject Telehealth use has increased dramatically since the COVID-19 pandemic, both for clinical services and student placements in allied health services in general as well as speech and language therapy (SLT). Student placements conducted via telehealth are beneficial for student learning but some skills such as communication and interpersonal interaction develop differently. Placements can involve students delivering clinical services via telehealth and/ or remote student supervision (tele-supervision). What this paper adds to existing knowledge By drawing on the perspectives of students and practice educators, this paper demonstrates that the processes used for supervision, planning and clinical services are different in telehealth compared to in-person placements. It reveals that SLT students and educators have strongly held perceptions about the value and equivalence of telehealth placements that change over the course of a telehealth placement. This paper suggests placements that combine telehealth with tele-supervision are more complex and have fewer opportunities for incidental learning and developing professional workplace skills than placements where the educator and student providing telehealth services are co-located. What are the potential or actual clinical implications of this work? This paper will help universities, professional organisations and practice educators disentangle placements where students deliver services using telehealth from those where students also receive tele-supervision. This work identifies common perceptions about telehealth placements that educators can use to guide discussions with students, and guide the selection of effective work practices for students and educators during telehealth placements.

The aim of the current study was to identify whether certain morphosyntactic constructs are more difficult for children with speech sound disorder than children with typical speech development. In this post-hoc study, we used chi-square analyses to identify group differences on individual questions on a standardised test of expressive morphosyntax. Participants included 80 preschool-age children, 40 with typical speech and language development (TD), and 40 with speech sound disorder and typical language development (SSD). A chi-square analysis revealed group (TD vs. SSD) differences in usage of subject pronouns, irregular past tense verbs, and yes/no interrogative formation. Ordinal logistic regression revealed that phonological awareness was related to irregular past tense verb use. Children with SSD may present with subclinical morphosyntax difficulties. Speech-language pathologists should consider incorporating morphosyntax assessment into test batteries for children with SSD.

Objectives: This study aims to examine the academic career awareness of undergraduate students in speech and language therapy. Patients and Methods: A total of 103 speech and language therapy students (81 females, 22 males; mean age: 22.8±2.3 years; range, 21 to 39 years) studying at universities were included in this study. Participants filled out a personal information form and the Academic Career Awareness Scale in Higher Education. Results: No statistically significant difference was found between the scale dimensions according to the sex of the participants, the type of university they attended, the type of high school they graduated from, the employment status of the mother and father, and the educational status of the mother and father (all p>0.05). Conclusion: It was observed that the participants had academic career awareness but not at the desired level. There is a need for training and activities in universities that will increase the academic career awareness of students.

Objective: To determine how confident final-year speech and language therapy (SLT) students feel regarding provision of intervention to youth offenders with communication disorders. This project looked specifically at confidence assessing adolescents, providing intervention to adolescents, and providing intervention to youth offenders. Method: A cohort of 23 final-year SLT students completed a questionnaire comprised of Likert and open-ended questions. Main results: Only 17% of the participants felt confident providing intervention to youth offenders with communication disorders; 70% of the participants felt confident assessing adolescents with communication disorders; while 53% felt confident providing intervention to adolescents. However, when specific areas of assessment and intervention were considered, there were gaps in confidence, including knowledge of typical adolescent communication development, provision of intervention for adolescent dysfluency and management of challenging behaviours. Conclusion: Final-year SLT students have much of the basic knowledge required to help youth offenders develop communication skills; however, most do not feel confident providing intervention to youth offenders with communication disorders. Undergraduate workshops and continuing professional development courses may facilitate transference of underlying skills to the provision of intervention to youth offenders with communication disorders.

This article describes a work‐place interprofessional learning experience for Speech and Language Therapy (SLT) students in an acute hospital, using an innovative model of Speech and Language Therapy students learning with students and qualified professionals from other disciplines. The experience was evaluated via a feedback form, use of the Readiness for Interprofessional Learning Scale (RIPLS) and group discussion. The study details feedback on the sessions, with participants reporting greatest benefit in terms of teamwork and collaboration. Student and tutor reflections on the learning experience are outlined and related to broader issues surrounding interprofessional learning in work‐place settings.

ABSTRACTBackgroundSimulated placements, including those within a telehealth setting, are increasingly being relied upon as an alternative to traditional placements within health professions degrees. Existing research is focused around evaluating the learning outcomes generated by simulation programs and advocates the comparable quality of traditional and simulated placements in some contexts. However, there is limited understanding of the nature of student reflections within speech and language therapy simulated placements, and no studies have explored student experiences in both in‐person and online simulation formats. Understanding salient student learning experiences will allow university educators to better tailor simulated placements towards students’ learning needs in either format and encourage effective reflection on critical practice skills.AimsThis study explores speech and language therapy student perceptions of their learning experiences following participation in a simulation placement in either telehealth or in‐person formats. It focuses on two research questions, (1) what aspects of their learning experience do students reflect on after one day in a simulated speech and language therapy placement? And (2) how are student reflections following simulation similar or different in telehealth and in‐person formats?Methods and proceduresThis study adopted an Exploratory‐ Descriptive‐Qualitative design. Two cohorts of mid‐program speech and language therapy students from one Australian university completed a simulation placement. Students interacted with the same learning activities, including the same standardised patient scenarios with roles played by actors, in either an online telehealth or in‐person format. Online discussion posts following the first day of a simulated placement from students in each format were analysed separately using Reflexive Thematic Analysis and then compared.Outcomes and resultsIn the telehealth format, 23 students consented to participate and in the in‐person format, 16 students consented to participate. In both simulation formats, students’ reflections were similar, with the same themes of (1) client‐centred communication, (2) emotions, (3) working collaboratively, (4) learning from and with others and (5) therapeutic approaches, being constructed. Each theme had two to four subthemes. Student reflections differed between the telehealth and in‐person simulation formats in four subthemes, two within client‐ centred communication and one each within working collaboratively and therapeutic approaches.Conclusion and implicationsFindings suggest that speech and language therapy students reflect upon similar areas of learning whether their simulation is in telehealth or in‐person formats. Further investigation across different professions and simulation programs is recommended to extend understanding of student reflection and better build learning opportunities for student reflection in simulation.WHAT THIS PAPER ADDSWhat is already known on this subjectSimulated placements are being used as alternatives to traditional placements in health professions degrees including speech and language therapy (SLT). Comparable learning outcomes have been shown for health professions students either for in‐person or online telehealth formats, but no studies have explored experiences in both formats.What this study adds to existing knowledgeBy exploring student reflections on their learning, this paper suggests that what is salient for SLT students on their first day of a simulated placement is in the areas of (1) communication, (2) emotions, (3) working collaboratively, (4) learning from and with others and (5) therapeutic approaches. The paper suggests that students’ reflections on their learning experiences are similar whether the simulation is in an in‐person or telehealth format.What are the potential or actual clinical implications of this study?This paper guides universities in designing learning experiences for SLT students to develop key competencies for practice within health services, whether they use in‐person or online telehealth contexts to provide effective care.

Placements are a core component of learning within speech and language therapy (SLT) undergraduate and postgraduate university programmes. They facilitate the development of students' professional and clinical competencies and socialization into the profession. It is indicated that an optimal environment for placement learning often pivots on the mentoring, supervision and feedback the student receives. To explore the perspectives of student SLTs in the Republic of Ireland in relation to factors that would best support their learning and competency development on placement. Qualitative data were collected from an anonymous online student survey that consisted of eight open-ended questions. Thematic analysis was applied to the data. Excerpts from the data were selected to illustrate the themes constructed. A total of 117 students responded. Four salient themes were generated that capture the students' perspectives of an optimal environment for placement learning and competency development. This study supports quality assurance within the practice education of student SLTs and highlights aspects of an optimal learning environment that practice educators can strive to develop. In parallel, this study points to the need for improved supports from university personnel and placement site managers, and an increased need for student preparedness and self-reflection. Implications for continuing professional development specific to the role of a practice educator is described, in addition to the recommendation of an expanded perspective of supervision within SLT. What this paper adds What is already known on the subject Placements are an integral component of SLT undergraduate and postgraduate university programmes that enable students to translate theory to practice. Placement involves a transition from structured and predictable learning of the classroom to more dynamic learning environment within the placement site. Assessment of placement is carried out by practice educators using competency assessment tools. An optimal environment for placement learning often pivots on the mentoring, supervision and feedback that the student receives from their practice educator. What this paper adds to existing knowledge This study explores student SLTs' voices in relation to what they consider an optimal environment for placement learning should be and what they believe may best support them in their journey to develop their clinical competencies. It supports quality assurance of the practice education of our future colleagues. What are the potential or actual clinical implications of this work? The findings of this enquiry emphasize the distinction between competence as a SLT and competence as a practice educator and have subsequent implications for the content of continuing professional development for practice educators. In particular, an expanded perspective of the models and frameworks of supervision to promote and implement within the practice education of SLT students is presented.

BackgroundChildren with speech sound disorders (SSD) form a heterogeneous group that differs in terms of underlying cause and severity of speech difficulties. Orofacial dysfunction and malocclusions have been reported in children with SSD. However, the association is not fully explored.ObjectivesOur aims were to describe differences in orofacial function and malocclusion between a group of children and adolescents with compared to without SSD and to explore associations between those parameters among the group with SSD.MethodsA total of 105 participants were included, 61 children with SSD (6.0–16.7 years, mean age 8.5 ± 2.8, 14 girls and 47 boys) and 44 children with typical speech development (TSD) (6.0–12.2 years, mean age 8.8 ± 1.6, 19 girls and 25 boys). Assessments of orofacial function included an orofacial screening test and assessment of bite force, jaw stability, chewing efficiency, and intraoral sensory‐motor function. Possible malocclusions were also assessed.ResultChildren with SSD had both poorer orofacial function and a greater prevalence of malocclusion than children with TSD. Furthermore, children with SSD and poorer orofacial function had a greater risk of malocclusion.ConclusionOur result suggests that children with SSD are more prone to having poorer orofacial function and malocclusion than children with TSD. This illustrates the importance of assessing coexisting orofacial characteristics in children with SSD, especially since orofacial dysfunction may be linked to an increased risk of malocclusion. This result highlights the need for a multiprofessional approach.

The publication of phase 2 of the CATALISE project in 2017 clarified terminology for children with developmental language disorder (DLD) or delay but unintentionally muddied the water for children with unintelligible speech. A diagnostic label of DLD (phonology) indicates poor prognosis and phonological disorder that persists into middle childhood. However, in contrast to other diagnostic labels that fall under the overarching term of speech sound disorder (SSD), DLD (phonology) does not elucidate the characteristics of the child's speech nor does it point us in the direction of appropriate intervention. The aim of this paper is to discuss terminology in SSD leading to an evidence-based model which builds on the model of DLD developed in CATALISE, supports descriptive diagnosis and signposts intervention. Following a focused review of literature proposing or describing terminology for SSD, an expert group of researchers in developmental SSD proposed a revised model of existing terminology. Groups of UK speech and language therapists (SLTs) who provide services for children with SSD were asked to comment on its acceptability and feasibility. A three-level terminology model was developed. This comprised an overarching Level 1 term; Level 2 terms that differentiated SSD of unknown origin from SSD with associated or underlying conditions; and specific diagnostic terms at Level 3 to support further assessment and intervention decisions. Consulted SLTs generally expressed agreement with the proposed terminology and a willingness to adopt it in practice. Existing terminology for childhood SSD provides a good basis for clinical decision-making. A modified version of Dodd's (2005) terminology was found to be acceptable to UK SLTs. There is an evident overlap of SSD with CATALISE terminology. However more detailed and specialist terminology than 'DLD (phonology)' is required to support clinical decision-making. It is proposed that endorsement by the UK Royal College of Speech and Language Therapists would obviate the need for a Delphi process. What is already known on this subject Over nearly a hundred years, as our knowledge and understanding of speech sound disorder (SSD) has increased, so has the terminology that is used to describe those disorders. Current terminology not only describes subtypes of SSD but can also signpost us to effective interventions. With the publication, in 2017, of phase 2 of CATALISE a new term of 'developmental language disorder (DLD) (phonology)' was introduced with the unintentional consequence of challenging more specific descriptive terms for SSD. What this paper adds In the context of CATALISE and DLD (phonology), the history and nature of SSD terminology are reappraised. Building on the model of DLD developed in CATALISE, a tiered model that supports descriptive diagnosis and signposts intervention is proposed for discussion. Clinical implications of this study The proposed model of terminology for SSD provides descriptive and detailed labels that will support accuracy in differential diagnosis of developmental SSD by speech and language therapists. Furthermore, a decision-making tree for SSD demonstrates the pathway from diagnostic use of the terminology to the selection of evidence-based, effective interventions.

Children with speech sound disorders (SSD) represent a large number of speech and language therapists’ caseloads. The intervention with children who have SSD can involve different therapy approaches, and these may be articulatory or phonologically based. Some international studies reveal a widespread application of articulatory based approaches in children with different SSD. In Portugal no survey has been previously conducted about speech and language therapists (SLTs) practices when working with children with SSD, so it is still unknown how SLTs treat children with SSD. This study aims to explore the use of different intervention approaches of SLTs in Portugal, and to describe the approaches most frequently used in treating children who have phonologically based SSD. Data collection was conducted through a questionnaire available on the web platform Advanced Communication and Swallowing Assessment (ACSA; http://acsa.web.ua.pt ), and data analysis was based on 88 responses, corresponding to 5% of the total Portuguese SLTs population. Results showed that the intervention approaches most used with children who have SSD are phonological awareness (97% of the participants), auditory discrimination (92%), meaningful minimal contrast therapy (75%) and parent-based work (58%). The great majority of SLTs combined several approaches in their intervention. There was also a high percentage of SLTs that used articulation based approaches, namely articulation work (31%) in cases of phonologically based disorders. Most (63%) SLTs used weekly interventions over a period of more than six months (51%). The data presented here agrees with the results obtained in South African, UK and USA studies in terms of the approaches most frequently used in intervention with children who have phonologically based SSD. Regarding the frequency and duration of intervention, there is a discrepancy between the results obtained and what is commonly used across research. The characteristics described by the Portuguese SLTs for establishing the differential diagnosis of SSD do not always reflect the evidence available in recent literature. The findings presented in this article revealed the intervention approaches that SLTs currently use to treat children with phonologically based SSD and the theoretical foundations that guide their clinical practice. This allows the reader to compare clinical practice of SLTs across countries and research studies.

Difficulties experienced by novices in clinical reasoning have been well documented in many professions, especially medicine (Boshuizen and Schmidt 1992, 2000; Elstein, Shulman and Sprafka 1978; Patel and Groen 1986; Rikers, Loyens and Schmidt 2004). These studies have shown that novice clinicians have difficulties with both knowledge and strategy in clinical reasoning tasks. Speech and language therapy students must also learn to reason clinically, yet to date there is little evidence of how they learn to do so. In this paper, we report the clinical reasoning difficulties of a group of speech and language therapy students. We make a comparison of a subgroup of these with experienced speech and language therapists' reasoning and proposes some methods and materials to aid the development of clinical reasoning in speech and language therapy students. Student diagnostic reasoning difficulties were analysed during the assessment of unseen cases on an electronic patient database, the Patient Assessment and Training System (PATSy http://www.patsy.ac.uk) (Lum et al. 2006). Pairs of students were videoed as they completed a one hour assessment of one of three 'virtual patients'. One pair of experienced speech and language therapists, who were not part of the project team, also completed an assessment of one of these cases under the same conditions. Screen capture was used to record all on screen activity within PATSy web pages (i.e. mouse pointer position, hyperlink and button presses, page scrolling, browser navigation interactions and data entered); Verbal comments made by participants were analysed via a seven-level coding scheme that aimed to describe the events that occur in the process of diagnostic reasoning. Students displayed a range of competence in making an accurate diagnosis. Diagnostically accurate students showed use of specific professional vocabulary, and a greater use of firm diagnostic statements. For the diagnostically inaccurate students, typical difficulties were a failure to interpret test results and video observations, difficulty in carrying out a sequence of tests consistent with a diagnostic reasoning path, and problems in recalling and using theoretical knowledge. We discuss how identification of student diagnostic reasoning difficulties can inform the design of learning materials intended to address these problems.

Purpose The aim was to compare movement patterns of lips and jaw in lateral, vertical and anteroposterior directions during vowel production in children with typical speech development (TSD) and in children with speech sound disorders (SSD) persisting after the age of six. Methods A total of 93 children were included, 42 children with TSD (6:0–12:2 years, mean age 8:9 ± 1:5, 19 girls and 23 boys) and 51 children with SSD (6:0–16:7 years, mean age 8:5 ± 3:0, 14 girls and 37 boys). Range of motion (ROM) in lips and jaw in the vowels [a, ʊ, ɪ] produced in a syllable repetition task and median values in resting position were measured with a system for 3D motion analysis. The analysis was based on the coordinates for the mouth corners and the chin centre. Results There were significant differences between the groups on movements in lateral direction in both lips and jaw. Children with TSD had generally smaller and more, symmetrical movements in the lips and jaw, in all three dimensions compared to children with SSD. There were no significant differences between the groups in resting position. Conclusion Children with SSD persisting after the age of six years show more asymmetrical and more variable movement patterns in lips and jaw during vowel production compared with children with TSD in a simple syllable repetition task. Differences were more pronounced in lateral direction in both lips and jaw.

ObjectivesThe objectives of this study were to investigate the occurrence, types and severity of malocclusions in children with speech sound disorder (SSD) persisting after 6 years of age, and to compare these findings to a control group of children with typical speech development (TSD).MethodsIn total, 105 children were included: 61 with SSD and motor speech involvement (mean age 8:5 ± 2:8 years; range 6:0–16:7 years, 14 girls and 47 boys) and 44 children with TSD (mean age 8:8 ± 1:6; range 6:0–12:2 years, 19 girls and 25 boys). Extra-oral and intra-oral examinations were performed by an orthodontist. The severity of malocclusion was scored using the IOTN-DHC Index.ResultsThere were differences between the SSD and TSD groups with regard to the prevalence, type, and severity of malocclusions; 61% of the children in the SSD group had a malocclusion, as compared to 29% in the TSD group. In addition, the malocclusions in the SSD group were rated as more severe. Functional posterior crossbite and habitual lateral and/or anterior shift appeared more frequently in the SSD group. Class III malocclusion, anterior open bite and scissors bite were found only in the SSD group.ConclusionChildren with SSD and motor speech involvement are more likely to have a higher prevalence of and more severe malocclusions than children with TSD.

Interprofessional Collaboration Between Audiologists, SLPs

Speech and language therapy (SLT) education must meet the needs of the future workforce, training enough students who are competent practitioners able to meet the workforce demands. Increasing student numbers and the impact on placement providers mean students must be equipped for learning on placement. Simulation is a way of supporting students to develop their clinical skills and decision-making in a safe, supportive environment. To explore the perspectives of SLT students who were introduced to simulation during their undergraduate degree at a UK university as part of a pilot study. The aim of the pilot was to listen to the students' voices to begin to understand their lived experiences of simulation and to gather views on how simulation can support their clinical learning. Focus groups and semi-structured interviews were carried out with second-year BSc SLT students in semester 2 following the simulated learning activities and clinical placement. Qualitative data were gathered and thematic analysis was applied to the data to identify the barriers and enablers to students' clinical learning in simulation. A total of 11 students responded out of a cohort of 38. Three key themes were identified from the analysis: individual learning needs, facilitator skill and programme-level organization. Student experience of simulation was positive. One of the key elements students found to support their clinical skills was the importance of the safe space; support for learning instead of correction led them to engage in active learning. Key barriers to simulation related to having sufficient prior knowledge, the skills of the facilitator, group size and the wider learning landscape of the programme. In response to this pilot, there are plans to continue developing this model of simulation and embed simulation across the programme, led by a sound pedagogical approach with clear preparation and planning and building the necessary infrastructure. Other SLT programmes and practice educators developing simulation as part of their programmes or placement may wish to consider some of these findings to support the use of simulation in their workplace. What is already known on this subject Simulation as a teaching methodology is widely used in medicine and nursing programmes. It is now used in various allied health professions and in some SLT programmes. There is evidence to suggest simulation increases student confidence and clinical skills without increasing the capacity on those offering clinical placements in practice. What is already known on this subject This study offers a practical example of introducing simulation in an established undergraduate programme for SLT students. It explains the background to this innovative way of teaching clinical skills and explains why this approach could be beneficial for the future speech and language therapist. What are the clinical implications of this work? This study gives practical examples of how simulation can work to facilitate student clinical learning and knowledge. It may offer ideas to those working in clinical practice to organize placements differently or add simulation elements to improve the student experience. Other educational establishments and placement educators may find the recommendations helpful in developing their own simulation approach.