Clinical Graduate Research Articles

Collaborative Script-Based Experiences for Bilingual Speech–Language Pathology Trainees

Bilingual speech–language pathology trainees face a dual challenge. They must gain clinical competence as defined by the American Speech-Language-Hearing Association's Knowledge and Skills Assessment (2003) and gain proficiency related to bilingual service delivery. Collaborative script-based experiences allow them to gain bilingual experience from the beginning of their training. In collaborative script-based experience, novice clinicians collaborate with expert clinicians and/or educators to reach common goals in service delivery. The graduate clinician carries out specific intervention tasks that may be scripted in Spanish. The bilingual supervisor scaffolds service delivery by directly participating in intervention planning and delivery. Collaborative learning scripts potentially shorten learning cycles because graduate clinicians have access to concrete feedback in context and make immediate changes in their teaching activities.

From the Editors

From the Editors

Problem-based learning, critical thinking and concept mapping in speech-language pathology education: A review

Despite speech-language pathology (SLP) education undergoing many innovative changes over the years, there has been little research about learning or outcomes in SLP programs. Critical thinking in clinical decision-making, however, has been identified as a critical skill in SLP. Several recent studies have shown that concept mapping can be used to assess, and perhaps enhance, critical thinking. Problem-based learning (PBL) is reported to be one way to encourage critical thinking and life-long learning. Here we review the literature in PBL, concept mapping, and critical thinking, focusing on the education of SLP students. The review illustrates the close and complex interactions amongst problem-based learning, critical thinking and concept mapping. The aim of the review is to provide a better understanding of the mechanism of PBL, and to increase understanding regarding why the employment of PBL in SLP programs may facilitate critically-thinking graduate clinicians. The evidence indicates that PBL allows more meaningful learning that promotes better integration between theory and clinical practice.

A programmatic study of short-term psychodynamic psychotherapy: Assessment, process, outcome, and training

The author reviews findings from his research program on short-term psychodynamic psychotherapy. A hybrid model of psychotherapy research is outlined that integrates efficacy and effectiveness methodology to examine interrelated issues regarding (a) psychological assessment, (b) psychotherapy process, (c) treatment outcome, and (d) training of graduate clinicians. The integration of applied clinical research initiatives into a doctoral training program, clinical implications, and directions for future research are also presented.

Are CAFAS Subscales and Item Weights Valid? A Preliminary Investigation of the Child and Adolescent Functional Assessment Scale

Presents a psychometric analysis of the Child and Adolescent Functional Assessment Scale (CAFAS), one of the most commonly used measures of functional impairment in youths with emotional and behavioral disorders. Specific aims of the current investigation were to (a) examine the conceptual organization of the CAFAS items, (b) explore its scaling properties, and (c) investigate its construct validity. In Phase 1, a group of advanced graduate students and clinicians rated CAFAS items with respect to the degree that they reflect the originally assigned subscales. In Phase 2, additional raters assigned severity values to the subset of CAFAS items selected from Phase 1. Items were then scaled using simplified successive intervals scaling techniques. Results show differences between new empirically derived item weights and the original scoring method. This investigation highlights the benefits of continued examination and critique of level-of-functioning scaling for diagnosis, treatment, and prognosis in children and adolescents.

Effects of training in short-term psychodynamic psychotherapy: changes in graduate clinician technique

Abstract This study investigates the effects of graduate clinician training in short-term psychodynamic psychotherapy (STPP; Book, 1998; Luborsky, 1984; Strupp & Binder, 1984; Wachtel, 1993) on the acquisition of techniques within and across two training cases. Sessions 3 and 9 from the first and second treatment cases of 15 graduate clinicians receiving structured training in STPP were examined for the frequency of psychodynamic–interpersonal (PI) therapeutic techniques. Results demonstrated that structured training in STPP led to a significantly increased use of PI therapeutic techniques both within and across cases. The authors also examined the frequency of cognitive–behavioral (CB) therapeutic techniques used by the graduate clinicians. No changes in the number of CB interventions were observed over the same set of sessions. Practical implications for the use of structured clinical training and issues pertinent to supervision in graduate education are reviewed. Finally, the impact of structured train...

Reading and Riding: A Summer Language-Literacy Camp for At-Risk Adolescents

Reading and Riding: A Summer Language-Literacy Camp for At-Risk Adolescents

Exploratory research in the measurement and modification of attitudes toward stuttering

Past studies attempting to both measure and change stuttering stereotypes using semantic differential scales have indicated that clinicians' attitudes toward stuttering have been negative, robust, and resistant to change. This study measured changes in clinicians' attitudes after viewing either a factual video depicting the fluency-evoking effects of altered auditory feedback or an emotionally insightful video depicting the negative social consequences of stuttering. Two groups of graduate speech-language pathology clinicians took part in this ABA study design measuring participant responses to the two videos. Twenty-one participants completed surveys before and after viewing an emotional documentary depicting the life of a young girl who stutters. Another group of 34 graduate clinicians completed surveys before and after viewing a brief factual video exhibiting the immediate amelioration of stuttering behaviors at both normal and fast speaking rates while under the effects of altered auditory feedback. While post-testing results indicated that both of these documentaries were associated with a few changes in perceptions of stuttering, such changes were subtle. Moreover, the few significant perceptual changes found cannot be considered a noteworthy success in modifying graduate clinicians' perceptions of stuttering so that they better resemble the stuttering population described by prior psychological and stuttering research. Future research, along with the fate of current and past methodologies attempting to change the negative stuttering stereotype, is discussed. Educational objectives (1) Readers will become familiarized with the negative stereotypes of persons who stutter; (2) readers will become familiarized with research attempting to modify negative perceptions of people who stutter; and (3) readers will become familiarized with possible explanations for the persistence of negative stuttering stereotypes.

Validity of an Observation Screening Instrument in a Multicultural Population

Due to the increase of linguistically and culturally diverse young children in our society, accurate screening for communication disorders is becoming increasingly difficult. The Davis Observation Checklist for Texas (DOCT) is an observational teacher checklist used to screen preschool children for communication disorders in Head Start programs in Texas. The goals of this study were to assess the sensitivity and specificity of the DOCT and to evaluate the concurrent validity of the DOCT with a multicultural population. Fifty-nine English-speaking children (20 Mexican American, 19 African American, 20 Anglo) were evaluated using an assessment battery that included the McCarthy Scales of Children's Abilities (1970), the Goldman-Fristoe Test of Articulation-Revised (1986), and an informal checklist to assess voice and fluency. Concurrent validity was evaluated by obtaining the percent agreement between the outcome of the assessment battery (administered by speech pathologists and graduate clinicians) and the DOCT (administered by Head Start teachers). Results of this study show the DOCT demonstrates adequate sensitivity (80%) and specificity (98%) values and agrees well with the criterion measure in identifying children with communication disorders in the 3 populations studied.

Reliability of Children's Ratings of Vocal Roughness

The purpose of this study was (a) to determine the reliability associated with school-age children's judgments of vocal roughness, (b) to obtain normal-abnormal cut-off values for these judgments, and (c) to compare children's ratings to adult clinician ratings of the same samples. Ten first, third, and fifth-grade children's ratings of normal and simulated abnormally rough vowel /a/ productions are described. Pupil ratings of normalcy and degree of severity are presented. Findings indicated that these judgments differentiated both degree and type of vowel roughness with inter and intrajudge reliability commensurate with that of graduate and postgraduate clinicians. These findings suggest a level of listening sophistication in children that is potentially useful, but not currently exploited, in most voice therapy programs.

Attribution of blame in incest among mental health professionals.

Attribution of blame was examined in three samples differing in education and experience (38 undergraduates, 31 graduate students, 37 MA clinicians). 106 subjects completed the Jackson Incest Blame Scale, which yields four blame factors, situation, victim, society, and offender. The four factor scores were analyzed using 2 (sex) X 3 (education) analysis of variance. Attribution of blame decreased as a function of more education. The blame scores of men were significantly higher than those of women on all factors except offender. The percentage of graduate students and clinicians indicating a history of sexual abuse fell in the upper range of estimates of incidence. Individuals with histories of abuse differed only on their attribution of blame to situational factors.

Computer-Managed Screening for Communication Disorders

Fifty children were administered a screening test for communication disorders under two conditions. Under one condition graduate clinicians administered the test in the traditional pencil and paper format. Under the second condition nonprofessionals administered a computer-managed version of the same test. It was found that the computer-managed screening test yielded satisfactory agreement for the language sections. The results of the articulation section of the screening test were ambiguous.

Sexual aspects of Rorschach administration.

Summary In a retrospective study of Psychology Department test files of a large state hospital, male graduate examiners who tested both male and female patients (matched for age and I.Q.) elicited a significantly greater (p = .05) number of Rorschach responses from female than male patients. By contrast, female graduate examiners elicited an equal number of Rorschach responses from male and female patients. The results were interpreted as reflecting tester bias on the part of the male graduate clinicians. However, generalizations from these data to other populations were avoided, particularly as replications using different patients and examiners of varying levels of experience appear warranted.