Shortage Of Speech-language Pathologists Research Articles

Speech Analysis of Patients with Cleft Palate Using Artificial Intelligence Techniques: A Systematic Review

Introduction: This systematic review examines the use of machine learning (ML) algorithms to detect hypernasal speech in patients with cleft palate (CP), which can persist after primary repair surgery, and require revision. Due to a shortage of speech language pathologists (SLPs), automated detection tools could help improve access to care in underserved areas. The study compares the characteristics and accuracy of different types of machine learning algorithms. Methods: On August 18, 2021, searches were conducted across 8 databases: PubMed, SCOPUS, Cochrane, IEEE, ACM, L&LB, PsychInfo, and CINAHL. Search terms used were: (Artificial Intelligence OR Machine Learning OR Neural networks AND Cleft lip OR Cleft palate OR Hypernasality OR Velopharyngeal Insufficiency). To be included, papers needed to describe ML algorithms for CP speech detection and report concordance to human professional speech clinicians. Results: Database searches yielded 135 unique articles. Five articles met full inclusion criteria and 3 additional articles were identified by hand searching references of articles that passed initial screening. These algorithms were categorized as either Feature Dependent non-Deep learning (n = 5) or Feature Dependent deep learning (n = 2) algorithms or Feature Independent deep learning (n = 3) algorithms. Their pooled average concordance were 0.85, 0.93, and 0.91 respectively. Their average training database sizes were 3587, 3921, and 6306 speech samples respectively. Conclusion: Machine learning algorithms have been shown to be an effective tool for the evaluation of hypernasal speech. This systematic review has shown that ML algorithms are able to detect hypernasality with high concordance, consistent with professional speech language clinicians in a rapid, and autonomous manner. ML algorithms can extend the reach of speech language pathologists and complement their gold standard, this long-term outcome monitoring has great potential to improve treatment outcomes.

Telepractice in the Treatment of Speech and Voice Disorders: What Could the Future Look Like?

Purpose: There is an ongoing technological revolution in the clinical tools used by speech-language pathologists (SLPs) to care for patients. The COVID-19 pandemic accelerated the pace of change and the shift to telepractice. Telepractice will continue to play a large role after the pandemic, but it is unclear what the future may look like. Our goal is to give SLPs an overview of how recent technological innovations may enhance synchronous treatment, enable asynchronous treatment, and broadly modify traditional clinical practice patterns while the patient spends less time in the clinic. Conclusions: Newer telepractice tools such as remote patient monitoring, digital phenotyping, virtual reality, and artificial intelligence may improve the therapeutic process by addressing the shortage of SLPs and the transition of therapy practices to the real world. We also highlight key barriers to this future, including lack of rigorous trials of advanced technologies and state licensure regulations.

Impact of Clinical Education of Student Clinicians on Speech-Language Pathologists' Productivity in Medical Settings

Purpose: The shortage of speech-language pathologists in the workforce in the United States has prompted investigation into possible causes and solutions, one of which is investigation of the productivity impact of the one-to-one student-to-instructor ratio in clinical education in medical settings. This study compared productivity percentages before and during the student placement to determine the impact of clinical education on productivity. Method: This study used a descriptive retrospective cohort within-subjects design, comparing the mean productivity of 95 clinical educators before and during a student rotation. Results: The results indicated that the mean productivity of the speech-language pathology clinical educator was significantly negatively impacted during the student rotation, and this negative impact lasted through Week 7 of the rotation. Discussion addressed possible reasons for this reduction in productivity. Conclusions: This information supports the long-held belief within the field that 1:1 clinical education of a student clinician negatively impacts the clinical educators' productivity. Additional research is needed to further explore (a) the impact of clinical education on productivity in medical settings and (b) modifications to graduate clinician training preparation for medical settings to reduce this productivity impact.

Multimodal Data Fusion of Electromyography and Acoustic Signals for Thai Syllable Recognition.

Speech disorders such as dysarthria are common and frequent after suffering a stroke. Speech rehabilitation performed by a speech-language pathologist is needed to improve and recover. However, in Thailand, there is a shortage of speech-language pathologists. In this paper, we present a syllable recognition system, which can be deployable in a speech rehabilitation system to provide support to the limited speech-language pathologists available. The proposed system is based on a multimodal fusion of acoustic signal and surface electromyography (sEMG) collected from facial muscles. Multimodal data fusion is studied to improve signal collection under noisy situations while reducing the number of electrodes needed. The signals are simultaneously collected while articulating 12 Thai syllables designed for rehabilitation exercises. Several features are extracted from sEMG signals and five channels are studied. The best combination of features and channels is chosen to be fused with the mel-frequency cepstral coefficients extracted from the acoustic signal. The feature vector from each signal source is projected by spectral regression extreme learning machine and concatenated. Data from seven healthy subjects were collected for evaluation purposes. Results show that the multimodal fusion outperforms the use of a single signal source achieving up to [Formula: see text] of accuracy. In other words, an accuracy improvement up to [Formula: see text] can be achieved when using the proposed multimodal fusion. Moreover, its low standard deviations in classification accuracy compared to those from the unimodal fusion indicate the improvement in the robustness of the syllable recognition.

Adoption of Telepractice for Speech-Language Services

Little information exists regarding the statewide adoption of telepractice, the delivery of speech-language services at a distance through telecommunications, for addressing the documented shortage of speech-language pathologists (SLPs) in rural communities. A statewide survey of directors of special education revealed that only two school districts out of 87 respondents had adopted telepractice as a means of addressing job vacancies, whereas 79% ( n = 69) of the districts had never considered telepractice. A lack of knowledge about telepractice was not the primary barrier to adoption. Instead, concerns about the validity of telepractice, technology-related concerns, and inadequate support staff were noted as barriers to adoption.

An Overview of Facilities Providing Clinical Services for Persons Who Stutter in Kuwait

Presently, no clear picture is available about the facilities providing clinical services for persons who stutter (PWS) in Kuwait. This information is crucial for any awareness program to be established in the future. The purpose of this study was to identify clinical facilities and speech-language personnel that provide services for PWS in Kuwait. Participants consisted of 21 clinical directors of governmental medical centers, non-profit clinics, and private clinics as well as department heads of governmental school clinics where speech-language services were provided. Participants were interviewed regarding the availability of speech-language services within their centers and whether or not PWS receive services. The results revealed that four out of five governmental medical centers with a total of 32 speech-language pathologists (SLPs) provided services for PWS. Additionally, 12 schools of special education were found to have 62 SLPs on their staff providing fluency services for students. Finally, two stand-alone private clinics and one non-profit clinic provided services for PWS. Results indicated an overall shortage of SLPs in the country, especially in medical settings. This study sets the foundation for a series of future studies investigating the type and quality of stuttering services provided by the identified facilities in Kuwait.

Finding Answers Regarding the 2 R's of Speech-Language Pathology Assistants (SLPA) Supervision: Regulations and Recommendations

The use of support personnel has the potential to help alleviate the national shortage of speech-language pathologists (SLPs). However, ensuring the proper use of support personnel can be challenging for supervisors due to differences in the regulations and requirements pertaining to speech-language pathology assistants (SLPAs). The purpose of this article is to review current regulations and recommendations regarding the supervision and use of support personnel in the field of speech-language pathology. Findings suggest that there are significant national variations in SLPA requirements. Supervisors can approach supervision by first investigating their state/local regulations regarding SLPAs and then familiarize themselves with the American Speech-Language-Hearing Association's (ASHA's) recommendations (which are highlighted in this article) for further guidance and clarification in this area. In light of the national inconsistencies in SLPA requirements, SLPAs and their supervisors are encouraged to advocate for more resources and to explore the concept of national standards as a possible way to address critical issues impacting the work of SLPAs and their supervisors.

Promoting change through political consciousness: A South African speech-language pathology response to the World Report on Disability

In the context of the World Report on Disability, question how speech-language pathologists (SLPs) change practices to benefit under-served people with communication disability. This commentary provides a South African response premised on Political Consciousness. In South Africa, a grossly unequal society, the under-served population is not only those with communication disability but also include those who are at a communication disadvantage due to disabling conditions. As a consequence of the combined effects of a severe shortage of SLPs as well as maldistribution in service provision, the under-served are mainly poor Black South Africans who are the majority population. Political Consciousness allows one to examine how selected forces at the macro-level, meso-level, and micro-level may enable or limit services to the under-served majority. At a macro-level, this study appraises policies and actions advancing and impeding service delivery. At the meso-level it is argued that hegemonic professional knowledge is limiting and an equity-driven population-based approach is advocated. At a micro-level, the Relationship of Labouring Affinities is offered as a conceptual tool for critical engagement. In conclusion, it is suggested that the speech-language pathology profession must collectively become political actors at all levels to effect change.

Regulating the Use of Support Personnel in Schools

Abstract Rules and regulations governing the use of support personnel in Arkansas were approved in 1996. These regulations allow school districts to employ support personnel, assistants or aides, to assist master's level speech-language pathologists (SLPs) with clerical and clinical tasks. School district personnel must develop proposals, receive approval, and participate in training before the support personnel can be used in the delivery of speech-language services. The supervising SLPs manage the caseload, provide direct services, and supervise the support personnel. This model of service delivery has been used effectively in Arkansas schools to enhance services provided by the SLPs. Support personnel are employed primarily in the rural parts of the state where there is a shortage of SLPs.

Preparing Alaskan Speech-Language Pathology Graduates for School-Based Employment

Abstract Alaska, like the rest of the nation, has been experiencing a significant shortage of speech-language pathologists (SLPs). This shortage has been acutely felt in Alaska's public schools. Without an in-state graduate program, Alaska is unable to produce a qualified pool of candidates to fill SLP positions. This article will discuss a collaborative training program between the University of Alaska Anchorage and East Carolina University designed to address the SLP shortage in Alaska schools.

What Makes a Caseload (Un)Manageable? School-Based Speech-Language Pathologists Speak

Large caseload sizes and a shortage of speech-language pathologists (SLPs) are ongoing concerns in the field of speech and language. This study was conducted to identify current mean caseload size for school-based SLPs, a threshold at which caseload size begins to be perceived as unmanageable, and variables contributing to school-based SLPs' feelings of caseload manageability. Approximately 2,000 public-school-based SLPs from across the country were solicited to participate in an online, Web-based survey between April and May of 2007. Of those SLPs who were contacted, 634 full-time SLPs from 49 states completed the survey. The data were evaluated using descriptive statistics and logistic regression. The mean caseload size for SLPs in this study was 49 students. At the caseload range of 41-50 students, approximately 60% of the SLPs perceived their caseload size as unmanageable. Logistic regression revealed caseload size, years of experience, and extent of collaboration as significant predictors of an SLP's likelihood of feeling that his or her caseload size is manageable. Caseload size continues to be an area of concern for school-based SLPs, and efforts to address this problem must continue in order to prevent long-term struggles with SLPs' dissatisfaction, shortages, and turnover. Policy, research, and clinical implications are discussed.

Retention of School-Based SLPs: Relationships Among Caseload Size, Workload Satisfaction, Job Satisfaction, and Best Practice

Nationally, the shortage of speech-language pathologists (SLPs) in the schools is growing. As such, it is important to understand factors related to the retention of SLPs in this setting. This study expanded on previous research by examining a wider range of factors that may be related to the retention of SLPs including caseload size, workload satisfaction, job satisfaction, and time available to conduct best practice. Participants were 75 full-time SLPs working in a school setting in the state of Vermont who completed a survey designed to solicit information concerning the variables of interest. Several dimensions of job satisfaction and best practice predicted retention, caseload, and especially workload. The results also suggested that high workloads complicate the implementation of best practice and have implications for retention. Limitations of the research and implications for practice are discussed.

Overview of Telehealth Activities in Speech-Language Pathology

It is estimated that 10% of the world's population, approximately 650 million people, have some form of disability. Population growth, aging, and medical advances that preserve and prolong life have increased demands for health and rehabilitation services. Recent predictions indicate a shortage of speech-language pathologists and other rehabilitation specialists to provide care for individuals with disabilities. The application of telemedicine and telehealth technologies offers effective solutions to this challenge. An extensive literature review was conducted that included technical reports, websites, publications from the American Speech-Language-Hearing Association, and peer-reviewed journal articles of telehealth applications in speech-language pathology. Various applications of telehealth in speech-language pathology are described including types of technology, patient and clinician satisfaction, advantages of using telehealth, challenges and barriers to application, and future directions. This review provides a strong foundation for broader applications of telehealth technologies in this area of healthcare.

Clarifying Differences in Definitions Between ASHA Policy Documents and the Authors in “The Critical Shortage of Speech-Language Pathologists in the Public School Setting: Features of the Work Environment That Affect Recruitment and Retention”

The January 2007 issue of Language, Speech, and Hearing Services in Schools includes an article by D. Edgar and L. Rosa-Lugo entitled "The Critical Shortage of Speech-Language Pathologists in the Public School Setting: Features of the Work Environment That Affect Recruitment and Retention." In their article, the authors cite the American Speech-Language-Hearing Association (ASHA) policy document "A Workload Analysis Approach for Establishing Speech-Language Caseload Standards in Schools: Guidelines" (ASHA, 2002) and include the term workload in their survey instrument and study results. However, their definition of workload differs from the definition in ASHA policy documents. In addition, they provide some information from the ASHA Technical Report on workload (ASHA, 2002) that may be misconstrued out of context. The purpose of this letter is to reduce the possibility of any misunderstanding on the part of readers by highlighting the differences in definitions between the authors' work and ASHA policy documents and by providing context for information from the policy document. D. Edgar and L. Rosa-Lugo should be commended for conducting research related to the successful recruitment and retention of qualified speech-language pathologists in schools. Hopefully, these comments will contribute to those discussions by clarifying important points.

Employment Setting Changes of SLPS in a Rural State

Serious shortages of speech-language pathologists (SLP) continue to exist in rural areas in spite of increasing numbers of available personnel and mandated provision of services. This study identifies employment change factors which impact on the shortage of SLPs in rural schools. A questionnaire was mailed to every nationally certified and state licensed SLP in a southern, rural state, requesting historical employment change information such as sequence and length of employment and reasons for accepting employment in each employment. Descriptive statistics were used to characterize group data. Results showed that respondents employed in schools remain longer in those positions than do their counterparts in healthcare. Despite popular opinion, when SLPs leaves a school for other employment, the majority take positions in other schools. Factors that facilitate these changes are discussed.

Meeting the Critical Shortage of Speech-Language Pathologists to Serve the Public Schools—Collaborative Rewards

This article presents a collaborative approach to providing graduate education to speech-language pathologists who are employed in public school districts. A partnership called the Central Florida Speech-Language Consortium was established among the University of Central Florida, 10 Central Florida school districts, and community agencies to address the issue of the critical shortage of speech-language pathologists in the public schools. The consortium program provided bachelor-level speech-language pathologists in the public schools the opportunity to obtain a master's degree while they continued to work in the schools. Key innovations of the program included: (a) additional graduate slots for public school employees; (b) modifications in the location and time of university courses, as well as practica opportunities in the schools; and (c) the participation and support of public school administrators in facilitating supervision and practicum experiences for the consortium participants. The consortium program resulted in an increase in the number of master's level and culturally and linguistically diverse speech-language pathologists available for employment in the public schools of Central Florida. Recommendations for facilitating future endeavors are discussed.