Behavior Checklist Research Articles

Program PECS (Picture Exchange Communication System) untuk Meningkatkan Kemampuan Berbicara Terstruktur pada Anak Autis

Most of children with autism have difficulty with their communication skill. One of the specific problems is about to combine words into structured sentences when they tried to speak. The purpose of this research was to examine the efficacy of PECS in improving of structured language skills to children with autism. Participants of this research consisted of two children who have been diagnosed with autism. Dependent variable of this study was structured language skill in speaking and independent variable of the study was The PECS Program which had been modified in some phases. The method that was used in this study is single-case research with A-B-A design. Behavior checklist was used as the instrument for this research, also data of this research were analyzed by visual inspection. The result of visual inspection analysis showed that there were some improvements in grammatical language skills of the participants throughout the PECS program.

Neurodevelopmental outcome at 2\xa0years of age in preterm infants with late-onset sepsis

Late-onset sepsis is associated with impaired neurodevelopmental outcome in preterm infants. This prospective cohort study aims to establish the effect of sepsis after 72 h of life on cognitive, psychomotor, and language development of preterm infants (below 32 weeks gestational age and/or below 1500 g). At 2 years corrected age, neurodevelopmental outcome was tested using Bayley’s Scales of Infant Development-II, Lexilijst (lexical development questionnaire), and behavior checklists. Of 117 patients included, 85 experienced blood culture–proven infection. Coagulase-negative staphylococci were responsible for 55% of the episodes. No significant differences were found in cognitive, motor, and behavioral scores or lexiquotient comparing patients with versus no proven infection. When comparing three groups (coagulase-negative staphylococci, other, and negative blood culture), a significant difference was found in composite cognitive scores (p = 0.016), in favor of the coagulase-negative staphylococci group versus other causal agent group (p = 0.007). No significant differences were found in other subscales.Conclusion: In this cohort, no differences were found in neurodevelopmental outcome at 2 years corrected age between proven and no proven infection groups; confirmation in larger cohorts with a control group is needed. Patients encountering coagulase-negative staphylococci sepsis showed a significant better cognitive outcome compared to other causal agents.What is Known:• Late-onset sepsis is associated with impaired neurodevelopmental outcome in preterm infants.What is New:• Preterm infants encountering late-onset sepsis by coagulase-negative staphylococci show a better cognitive outcome in comparison to other causal infectious agents in this cohort.• No differences were found in neurodevelopment at 2 years of age in preterm infants with suspected lateonset sepsis, between proven and no proven infection groups. Confirmation is needed in larger cohorts with a substantial control group.

Discourses of Expertise in Professional Competency Documents: Reference Expertise as Performance

This article examines how reference and information service (RIS) expertise is framed by professional associations in their professional competency documents. Taking a discourse analysis approach, we analyzed how professional associations articulate and frame expertise in RIS competency documents. Three discourse categories were identified: expertise as domain knowledge, expertise as technical knowledge, and expertise as performance. Through these discourses, RIS expertise was transformed into a checklist of behaviors that practitioners are expected to perform and excluded core areas of library and information studies theoretical knowledge, such as theories of information behaviors, from professional practice. Understanding how RIS expertise is framed will provide insights into the role that competency documents play in the professional practices of library and information professionals.

Hair Cortisol Concentration and Mental Disorder in Children With Chronic Physical Illness

Background To examine changes in hair cortisol concentrations (HCC) in children with chronic physical illness and identify patterns of association between HCC and mental comorbidity. Methods A sample of 50 children aged 6 to 16 years were recruited within six months of being diagnosed with a chronic physical illness. Data were collected via hair samples, structured interviews, and behavioral checklists. Results There was no change in HCC over six months. Baseline HCC was associated with internalizing—odds ratio (OR) = 1.29 (90% confidence interval (CI): 1.01–1.66)—and externalizing disorders—OR = 1.32 (90% CI: 1.07–1.64). Externalizing disorder at six months was associated with elevated baseline—OR = 1.25 (90% CI: 1.02–1.53)—and six-month HCC—OR = 1.25 (90% CI: 1.02–1.54). Associations between HCC and mental disorder weakened over time, and for internalizing disorders, changed direction (i.e., inverse association), albeit not significantly. Conclusion Results provide preliminary evidence that physiological stress, measured using HCC, may be implicated in the relationship between physical and mental illness, and these associations align with attenuated stress responses over time.

Functional and structural networks of lateral and medial orbitofrontal cortex as potential neural pathways for depression in childhood.

Converging evidence suggests that the lateral and medial orbitofrontal cortices (lOFC and mOFC) may contribute distinct neural mechanisms in depression. This study investigated the relations of their functional and structural organizations with postnatal maternal depressive symptoms in young children. Resting-state functional magnetic resonance imaging and structural magnetic resonance imaging were acquired in children at age 4 (n=199) and 6 years (n=234). Child's withdrawal behavior problems were assessed using Child's Behavior Checklist. In 4-year-old girls, postnatal maternal depressive symptoms were positively associated with the lOFC functional connectivity with the visual network but negatively with the cognitive control network. The lOFC functional connectivity with the visual network and cerebellum, which was influenced by postnatal maternal depressive symptoms, was also associated with child's withdrawal behavior problems in 6-year-old girls. Moreover, postnatal maternal depressive symptoms were also negatively associated with the mOFC functional connectivity with the cognitive control and motor networks in 4-year-old girls. Furthermore, postnatal maternal depressive symptoms influenced the structural connectivity of left mOFC with the right middle frontal cortex and left inferior temporal cortex in 4-year-old girls. Unlike girls, boys showed that postnatal maternal depressive symptoms selectively impacted the mOFC functional connectivity with the memory system at age 6 years. Our study provided novel evidence on the distinct neural mechanisms of the lOFC and mOFC structural and functional organizations for intergenerational transmission of maternal depression to the offspring. Boys and girls may potentially employ different neural mechanisms to adapt to maternal environment at different timings of early life.

Behavior problems and health-related quality of life in Dravet syndrome

ObjectiveBehavior problems in Dravet syndrome (DS) are common and can impact the lives of patients tremendously. The current study aimed to give more insight into (1) the prevalence of a wide range of specific behavior difficulties and aspects of health-related quality of life (HRQoL) in patients with DS compared with the general population (gp) and patients with epilepsy without DS, (2) the relations between these behavior problems and different aspects of HRQoL, and (3) the associations between seizure frequency, cognitive impairment (CI), behavior problems, and HRQoL, based on a conceptual model. MethodsOne hundred and sixteen patients (aged between 2 and 67 years), affected by SCN1A-related seizures, were included in the study. Eighty-five were patients with DS, 31 were patients with epilepsy without DS. Behavior problems were measured using the Child/Adult Behavior Checklist (C/ABCL), HRQoL was measured using the Pediatric Quality of Life Inventory (PedsQL) Measurement Model. Other characteristics were obtained by clinical assessments, medical records, and semi-structured telephone interviews with parents. Comparisons between patients with DS, patients without DS, and the gp were calculated by the exact goodness of fit χ2 analyses, relations between subscales were analyzed using Pearson's correlations, and the conceptual model was tested in a path analysis. Results(1) Patients with DS show significantly more behavior problems compared with the gp and patients with epilepsy without DS. A total of 56.5% of patients with DS scored in the borderline and clinical ranges for total behavior problems. Problems with attention were most prevalent; 62.3% of patients with DS scored in the borderline and clinical ranges. Health-related quality of life was significantly lower for patients with DS compared with the gp and patients without DS. Physical and social functioning scores were especially low and decreased even more in the older age categories. (2) Problems with attention, aggression, and withdrawn behavior were most related to social functioning. Somatic problems and anxiety/depression were most related to emotional functioning. (3) Cognitive impairment and behavior problems were both independent predictors of poorer HRQoL in patients with DS, with behavior problems being the strongest predictor. Seizure frequency was only indirectly related to HRQoL, mediated by cognitive impairment. ImplicationsThe high prevalence of behavior problems in DS and the significant impact on quality of life (QoL), independent of epilepsy-related factors, emphasize the need for active management and treatment of these problems and should be considered as part of the management plan.

Modeling of an Observation Checklist of Motor Behavior

Research background and hypothesis. The study started with the hypothesis that direct observation of a child could be used as part of assessment of various internal problems. The results of recent observational studies on depressed children show that explicit behavioral symptoms of depression, such as psychomotor agitation, can be systematically observed during standardized procedures. Research aim. The aim of the study was to construct a checklist of motor behavior for children aged 11–12 years with internal problems. Research methods. Items for the checklist were recorded from DSM-IV and ISD-100. Children of 11–12 years (n = 75) were videotaped whilst participating in physical education lessons. Achenbach’s Child Behavior Checklist (Youth Self-Report for Ages 11–18 (YSR) and Teachers’ Report Form for Ages 5–18 (TRF)) were applied to the sample as well. The results from YRS and TRF were used for the development of validity statistics. Reliability statistics was calculated as well.Research results. The 14 statements were selected for the development of observation of motor behavior for children with internal problems. Result showed that the internal consistency (Cronbach’s α = 0.79) and reliability (ICC = 0.81) of the checklist were good. The insignificant result of dispersion among the observer group (F = 7.233, (df = 4) p = 0.423) showed that the observers agreed when assessing children.Discussion and conclusions. The instrument will be useful in screening children with possible internal problems and assisting in intervention planning aimed at influencing motor behavior. The study has a number of limitations – the sample is too small, the more extensive check of validity and reliability is required.Keywords: observation, internal problems, protocol of motor behavior, validity, reliability.

Behavior Assessment Battery: Normative and Psychometric Investigation Among Polish Adults Who Do and Do Not Stutter.

The aim of this study was to establish normative data for Polish persons who stutter (PWS) and persons who do not stutter (PWNS) with the adapted version of the Behavior Assessment Battery (BAB; Vanryckeghem & Brutten, 2018) for adults and to investigate whether or not gender and age influenced the results. In addition, the BAB subtests' reliability and validity were examined. A Polish version of the BAB test procedures, including the Speech Situation Checklist-Emotional Reaction, Speech Situation Checklist-Speech Disruption, Behavior Checklist, and Communication Attitude Test for Adults Who Stutter (Vanryckeghem & Brutten, 2018), were individually administered to 123 adults who stutter and 151 adults who do not stutter between the ages of 17 and 70. PWS scored statistically significantly higher on all BAB subtests compared to PWNS. No significant between-groups gender or age difference was detected. The test data indicate high internal validity. The test items correlate well with the total score and significantly differentiate the two groups. The test battery validly differentiates PWS from PWNS with high accuracy. The Polish version of the BAB for adults confirms data collected in previous cross-cultural investigations. The results once again differentiate PWS from PWNS in a powerful way. Compared to PWNS, PWS report significantly more anxiety and speech breakdown when speaking in particular speech situations. They also report their attitude toward speech to be significantly more negative compared to the typical speaker and indicate using a significant number of coping behaviors to avoid or escape difficult speaking conditions. The BAB test battery, in its totality, assists in multidimensional assessment, pre- and posttreatment comparison, and identification of treatment targets based on the answers of PWS to each test item.

A Comparative Analysis of Three Screening Methods for Nonsuicidal Self‐Injury in College Students

This study compared college students’ (N = 260) responses on a simple dichotomous screening measure and 2 behavior checklists. Seventy‐nine participants (30.4%) screened positive (i.e., endorsed nonsuicidal self‐injury [NSSI] behavior) on at least 1 measure, and 37 (46.8%) screened positive on the simple screen. Participants who screened positive on the simple screen reported more forms and instances of NSSI than did those who screened positive only on the checklist measures. They also reported significantly greater psychological distress compared with all other participant groups.

Standardized Patient Simulation Experiences Improves Mental Health Assessment and Communication

BackgroundAlthough simulation experiences are receiving increasing attention in nursing education, evidence is inconclusive regarding their effect on enhancing students' competency conducting mental health assessments and communicating effectively. SampleThis study examined whether engaging standardized patients (SPs) in a simulated home environment enhanced Bachelor of Science in Nursing students' competency (N = 32) in assessment and communication with patients with mental health conditions. MethodThe intervention group completed six SP scenarios (two hours), followed by debriefing. The control group received traditional education alone. Students completed pre–post tests, satisfaction surveys, and behavioral checklists. ResultsThe greatest knowledge deficits were in the assessment of clients with bipolar disease, symptoms of lithium toxicity, posttraumatic stress disorder, and stages of dementia. On average, intervention students significantly improved their posttest scores by 12.4 ± 16.8 points (p = .01). ConclusionSimulation with an SP improved posttest knowledge but not longer term outcomes; students reported high satisfaction with the experience.

Cognition, Health-Related Quality of Life, and Psychosocial Functioning After GH/GnRHa Treatment in Young Adults Born SGA.

Children born small for gestational age (SGA) with a poor adult height (AH) expectation benefit from treatment with GH and additional gonadotropin-releasing hormone analog (GnRHa). Because both SGA birth and GnRHa treatment might negatively influence cognition, health-related quality of life (HRQoL), and psychosocial functioning, we assessed these outcomes at AH. A randomized, dose-response GH study until AH involving 99 adolescents born SGA, of whom 61 children received 2 additional years of GnRHa treatment. At AH, the Wechsler Adult Intelligence Scale and TNO-AZL Adults Quality of Life questionnaire were administered to the study group. Additionally, the study group and 67 adolescents born SGA (19 GnRHa) from a second study group completed the Self-Perception Profile of Adolescents and Child/Adolescent Behavior Checklist at AH. Scores in GH-treated young adults with GnRHa treatment (GH/GnRHa group) were compared with GH-treated adolescents without GnRHa treatment (GH group) and a reference population. Mean age (SD) at AH was 17.5 (1.2) and 17.4 (1.4) years in the GH/GnRHa and GH group, respectively. Intelligence quotient scores were similar in GH/GnRHa and GH groups (96.33 vs 92.47). HRQoL was similar between both groups and also when compared with the reference population, but the GH/GnRHa group had a significantly lower perception of cognitive functioning. Self-perception and problem behavior were similar in the GH/GnRHa and GH groups. AH did not correlate with HRQoL, self-perception, or problem behavior. Combined GH/GnRHa treatment has no long-term negative effects on cognition, HRQoL, self-perception, and behavior in early adulthood, compared with GH treatment only.

Motor and non-motor determinants of health-related quality of life in young dystonia patients

ObjectivesTo systematically investigate the relationship between motor and non-motor symptoms, and health-related quality of life (HR-QoL) in children and young adults with dystonia. MethodsIn this prospective observational cross-sectional study, 60 patients (6–25 years) with childhood-onset dystonia underwent a multidisciplinary assessment of dystonia severity (Burke-Fahn-Marsden Dystonia Rating Scale, Global Clinical Impression), motor function (Gross Motor Function Measure, Melbourne Assessment of Unilateral Upper Limb Function), pain (visual analogue scale), intelligence (Wechsler Intelligence Scale), executive functioning (Behavior Rating Inventory of Executive Function) and anxiety/depression (Child/Adult Behavior Checklist). Measures were analyzed using a principal component analysis and subsequent multiple regression to evaluate which components were associated with HR-QoL (Pediatric Quality of life Inventory) for total group, and non-lesional (primary) and lesional (secondary) subgroups. ResultsPatients (29 non-lesional, 31 lesional dystonia) had a mean age of 13.6 ± 5.9 years. The principal component analysis revealed three components: 1) motor symptoms; 2) psychiatric and behavioral symptoms; and 3) pain. HR-QoL was associated with motor symptoms and psychiatric and behavioral symptoms (R2 = 0.66) for the total sample and lesional dystonia, but in the non-lesional dystonia subgroup only with psychiatric and behavioral symptoms (R2 = 0.51). ConclusionsNon-motor symptoms are important for HR-QoL in childhood-onset dystonia. We suggest a multidisciplinary assessment of motor and non-motor symptoms to optimize individual patient management.

Signs of struggle (SOS): The development and validation of a behavioural mental health checklist for the workplace

ABSTRACTFor managers to successfully support employee access to mental health resources, they must first be able to recognise if and when an employee may need help. To manage employees effectively, managers must be able to recognise changes in employees’ work behaviour that may indicate when an employee is struggling at work. In study 1, we develop and establish the structure of the 20-item Signs of Struggle (SOS) checklist as comprising five factors that describe the warning signs of health impairment at work (i.e. distress, withdrawal, reduced attendance, degradations in performance, extreme behaviours). In study 2, we show that manager-rated signs of struggle correlated substantially (r = .72) with participant-reported strain. The SOS tool provides managers a way to recognise when employees may be struggling and could benefit from workplace resources. We recommend that for maximal benefit, managers also receive training on how to use the SOS, and also on how to approach and assist employees who are displaying warning signs.

The development of teachers’ knowledge and behaviour in promoting self-discipline: a study of early years teachers in Thailand

ABSTRACTThe study reported in this paper examines the challenges of developing an in-service training programme for early years teachers in a school in Thailand relating to the topic of enhancing young children’s self-discipline. It is argued that in-service training in Thailand has tended to focus on knowledge acquisition through direct instruction during short courses. By contrast, the training programme developed during the project employed the Socialisation, Externalisation, Combination and Internalisation (SECI) Model, first developed in Japan, that integrates knowledge acquisition with social learning activities. A blended methodology was employed to examine the efficacy of the SECI approach that included interviews with teachers and school leaders, classroom observation, questionnaires and behaviour checklists. Findings suggest that an adapted SECI model is effective in the education of teachers in Thailand and may have relevance more widely in the field of teacher education in other nations.

How Well Do Rheumatology Fellows Manage Acute Infusion Reactions? A Pilot Curricular Intervention.

Infusible disease-modifying antirheumatic drugs (DMARDs) are commonly prescribed in rheumatology and other fields. There are no published formal educational curricula that rheumatology fellowship programs can use to teach infusion reaction management skills to fellows. We aimed to better understand this educational gap and implement and assess the effectiveness of an experiential curriculum on acute infusion reaction management. We included current rheumatology fellows and recent graduates from 5 fellowship programs. Using a novel behavioral checklist, we assessed fellows' performance managing an infusion reaction in a simulation, followed by a didactic session focused on infusion reactions. Pre- and postsurveys assessed experiences to determine relevance, as well as attitudes and knowledge. Despite ubiquitous prescribing of infusible biologic DMARDs, >50% of fellows were uncomfortable managing infusion reactions. Only 11% of fellows reported infusion reaction training during fellowship, but 56% reported managing actual patient infusion reactions. In the simulated infusion reaction, fellows managed grade-1 reactions appropriately, but grade-4 reactions poorly, meeting <50% of objectives. All fellows discontinued the infusion in the setting of anaphylaxis, but only 56% administered epinephrine. There was no difference in performance or written knowledge by training year. All fellows felt more prepared to manage infusion reactions postcurriculum and were satisfied with the experience. We confirmed an education gap in rheumatology fellowship training regarding infusion reactions, both in knowledge and performance. We developed and implemented a brief experiential curriculum including simulation of a high-risk patient-care scenario. This curriculum was well received and is easily exportable to other programs.

Using integrated arts programming to facilitate social and emotional learning in young children with social cognition challenges

ABSTRACTThe purpose of this article is to describe a school-based, integrated arts programme designed to facilitate social and emotional learning (SEL) in young children with social cognitive challenges, and to report on student outcomes. Students received weekly arts instruction over the course of one academic semester as part of their social studies curriculum. SEL instruction was infused throughout. Authors conducted an exploratory study of outcomes using a mixed methods design. We quantified behavioural outcomes for 16 focus students at baseline and again at the end of the programme using a behavioural checklist and several social skills measures. We also gathered qualitative data, specifically end-of-programme interviews with 27 key stakeholders (i.e. instructors and parents). Findings indicated that students made significant gains based on the checklist and social skills measures. Qualitative data indicated that instructors used arts programming to facilitate student growth across all five of CASEL’s SEL domains: self-awareness, self-management, social awareness, relationship skills, and responsible decision making.

Factor Structure, Validity, and Reliability of the Checklist of Risk Behaviours for Youth (CORBY)

Factor Structure, Validity, and Reliability of the Checklist of Risk Behaviours for Youth (CORBY)

Reliability and Validity of the Behavioral Check List for Preschool Children to Measure Attention Deficit Hyperactivity Behaviors

Nowadays, attention deficit hyperactivity (ADH) problems are observed commonly among school-age children. However, questionnaires specific to ADH behaviors among preschool children are very few. The aim of this study was to investigate the reliability and validity of the 25-item Behavioral Check List (BCL), which was developed from interviews of parents with children who were diagnosed as having Attention-deficit/hyperactivity disorder (ADHD) and measures ADH behaviors in preschool age. We recruited 22 teachers from 10 nurseries/kindergartens in Miyagi Prefecture, Japan. A total of 138 preschool children were assessed using the BCL. To investigate inter-rater reliability, two teachers from each facility assess seven to twenty children in their class, and intraclass correlation coefficients (ICCs) were calculated. The teachers additionally answered questions in the 1/5-5 Caregiver-Teacher Report Form (C-TRF) to investigate the criterion validity of the BCL. To investigate structural validity, exploratory factor analysis with promax rotation and confirmatory factor analysis were performed. The internal consistency reliability of the BCL was good (α = 0.92) and correlation analyses also confirmed its excellent criterion validity. Although exploratory factor analysis for the BCL yielded a five-factor model that consisted of a factor structure different from that of the original one, the results were similar to the original six factors. The ICCs of the BCL were 0.38-0.99 and it was not high enough for inter-rater reliability in some facilities. However, there is a possibility to improve it by giving raters adequate explanations when using BCL. The present study showed acceptable levels of reliability and validity of the BCL among Japanese preschool children.

A comparative study of maternal-neonate abdominal and kangaroo (skin-to-skin) skin contact immediately after birth on maternal attachment behaviors up to 2 months.

BACKGROUND:Early skin-to-skin maternal–neonate contact during the 1st h following birth prepares both mother and baby to establish a two-way, interactive pattern of interaction. There are few studies on the use of kangaroo care method in term infants and maternal postpartum behavior.OBJECTIVE:The present study aimed to compare abdominal and kangaroo skin contact on maternal attachment behaviors.SETTINGS AND DESIGN:This single-blind randomized clinical trial was performed on 68 eligible pregnant women in Torbat Heydariyeh in 2015.MATERIALS AND METHODS:Individuals were randomly divided into experimental groups (kangaroo skin contact) and control group (abdominal skin contact). Maternal attachment behaviors were observed for 15 min during 1 h postpartum. Each minute was divided into two 30 s, during the first and second 30 s of which the maternal behavior was observed and recorded using a checklist of behavior. Attachment behaviors were assessed using an attachment behavior checklist (including three types of emotional, proximity-seeking, and caring behaviors).STATISTICAL ANALYSIS USED:After data coding, the analysis was performed using Kruskal–Wallis test, Chi-square test, t-test, and Mann–Whitney test in SPSS ver. 14. P < 0.05 was considered the significant level.RESULTS:Among emotional, proximity-seeking, and caring behaviors 1 h and 2 months’ postpartum in the two groups, only proximity-seeking behaviors were significantly different 2 months’ postpartum (P = 0.033). The attachment behavior of 1 h (0.134) and 2 months’ postpartum (0.051) did not differ significantly between the two groups.CONCLUSIONS:Kangaroo skin contact has an effect, similar to the abdominal skin contact, on the maternal attachment behaviors and has a positive effect on proximity-seeking behaviors and some components of emotional behaviors compared to abdominal skin contact.

Communication-related affective, behavioral, and cognitive reactions in speakers with spasmodic dysphonia.

ObjectivesTo investigate the self‐perceived affective, behavioral, and cognitive reactions associated with communication of speakers with spasmodic dysphonia as a function of employment status.Study DesignProspective cross‐sectional investigationMethods148 Participants with spasmodic dysphonia (SD) completed an adapted version of the Behavior Assessment Battery (BAB‐Voice), a multidimensional assessment of self‐perceived reactions to communication. The BAB‐Voice consisted of four subtests: the Speech Situation Checklist for A) Emotional Reaction (SSC‐ER) and B) Speech Disruption (SSC‐SD), C) the Behavior Checklist (BCL), and D) the Communication Attitude Test for Adults (BigCAT). Participants were assigned to groups based on employment status (working versus retired).ResultsDescriptive comparison of the BAB‐Voice in speakers with SD to previously published non‐dysphonic speaker data revealed substantially higher scores associated with SD across all four subtests. Multivariate Analysis of Variance (MANOVA) revealed no significantly different BAB‐Voice subtest scores as a function of SD group status (working vs. retired).ConclusionsBAB‐Voice scores revealed that speakers with SD experienced substantial impact of their voice disorder on communication attitude, coping behaviors, and affective reactions in speaking situations as reflected in their high BAB scores. These impacts do not appear to be influenced by work status, as speakers with SD who were employed or retired experienced similar levels of affective and behavioral reactions in various speaking situations and cognitive responses. These findings are consistent with previously published pilot data. The specificity of items assessed by means of the BAB‐Voice may inform the clinician of valid patient‐centered treatment goals which target the impairment extended beyond the physiological dimension.Level of Evidence2b