Speech Therapy Research Articles

Vocapedia Reborn: A True Wiki Resource for Voice Teachers

Abstract: Vocapedia is NATS’ online information resource. In existence since 2014, Vocapedia has recently undergone a transformation into a true wiki format. In this article, the author reviews the history of Vocapedia, discusses its new format, and urges voice teachers, collaborative pianists, choral directors, speech language pathologists, voice researchers, and others who enjoy and study the voice to contribute to the resource and to refine and update its content.

Speech sound errors in adolescents with congenital hearing loss

Children with hearing impairment (HI) often have vowel and consonant errors. Speech-language pathologists need this information to correct articulation errors. Despite the prevalence of research on speech sound error patterns in hearing aid users, there is a lack of literature in the adolescent group. The present study aimed to investigate the common speech sound errors in HI adolescents from the Malayalam-speaking community who have severe to profound hearing loss and are digital hearing aid users. A total of 15 monolingual Malayalam-speaking children between the ages of 9 and 16 years were recruited who had been diagnosed with speech sound disorders secondary to congenital hearing impairment. The minimum language age for inclusion in the study was over three years. Articulatory error analysis was performed for all consonants and vowels of the Malayalam language, and frequently produced vowel and consonant errors were included in the SODA and PMV analyses. The consonants frequently produced speech sound errors and no vowel errors were found. The most commonly produced consonant errors were fricatives, trills, laterals, velars, and alveolars. Substitution and omission errors were the most common type of error. Place and manner errors were more common than other types of errors. The results of this study may help parents and rehabilitation professionals to understand the common errors that persist even after intensive intervention. It may also be a useful guide for AAC therapists and speech-language pathologists in setting appropriate speech production goals for adolescents with HI.

Interventions and evaluation to improve oral health in patients with stroke: a scoping review

Objectives: This scoping review aimed to identify and analyze intervention strategies and assessment methods for oral hygiene management (OHM) and oral function management (OFM) in patients with stroke admitted to general wards, with the goal of providing directions for future research. Methods: We conducted a comprehensive literature search on studies published over the past 10 years across databases, including Cochrane, Embase, Medline, PubMed, and ProQuest. A total of 18 studies met the inclusion and exclusion criteria. Results: In the OHM studies (N=7), oral hygiene care was primarily provided by nurses, dental assistants, and nursing care aides. Oral hygiene was assessed using plaque and gingival bleeding indices with products such as electronic toothbrushes and mouth rinses. In the OFM studies (N=11), care was provided by speech-language pathologists, occupational therapists, and dental hygienists. Assessment tools included the Functional Oral Intake Scale, the PenetrationAspiration Scale, and Video Fluoroscopic Swallowing Studies. Conclusions: Improving the oral health of patients with stroke requires both hygiene and functional management. Therefore, it is necessary to develop a method that provides specialized oral care tailored to the hospitalization environment and the specific conditions of patients with stroke.

Voice Assessment in Patients with Amyotrophic Lateral Sclerosis: An Exploratory Study on Associations with Bulbar and Respiratory Function

Background: Speech production is a possible way to monitor bulbar and respiratory functions in patients with amyotrophic lateral sclerosis (ALS). Moreover, the emergence of smartphone-based data collection offers a promising approach to reduce frequent hospital visits and enhance patient outcomes. Here, we studied the relationship between bulbar and respiratory functions with voice characteristics of ALS patients, alongside a speech therapist’s evaluation, at the convenience of using a simple smartphone. Methods: For voice assessment, we considered a speech therapist’s standardized tool—consensus auditory-perceptual evaluation of voice (CAPE-V); and an acoustic analysis toolbox. The bulbar sub-score of the revised ALS functional rating scale (ALSFRS-R) was used, and pulmonary function measurements included forced vital capacity (FVC%), maximum expiratory pressure (MEP%), and maximum inspiratory pressure (MIP%). Correlation coefficients and both linear and logistic regression models were applied. Results: A total of 27 ALS patients (12 males; 61 years mean age; 28 months median disease duration) were included. Patients with significant bulbar dysfunction revealed greater CAPE-V scores in overall severity, roughness, strain, pitch, and loudness. They also presented slower speaking rates, longer pauses, and higher jitter values in acoustic analysis (all p < 0.05). The CAPE-V’s overall severity and sub-scores for pitch and loudness demonstrated significant correlations with MIP% and MEP% (all p < 0.05). In contrast, acoustic metrics (speaking rate, absolute energy, shimmer, and harmonic-to-noise ratio) significantly correlated with FVC% (all p < 0.05). Conclusions: The results provide supporting evidence for the use of smartphone-based recordings in ALS patients for CAPE-V and acoustic analysis as reliable correlates of bulbar and respiratory function.

Inequalities in access to early child services in Bulgaria

Abstract Background Children’s health has been a major focus of European health policy since 2000, with particular emphasis on early childhood and integrated services for children with chronic diseases. However, research on early child care in Bulgaria is sparse, mainly focusing on the role of nurseries, kindergartens and nursing care. Our aim is to investigate whether there are disparities in access to early childhood health services in Bulgaria. Methods A survey was conducted among mothers of children up to 7 years old between April and June 2022. The questionnaire, containing 49 questions, was based on the theoretical framework from the EU project ‘Models of child health appraise’, covering topics as: geographical and financial access to services, equity, quality, responsiveness to children and family needs, considered key features of outpatient child medical care. Statistical analysis utilized Chi-square, Fisher’s exact and ANOVA tests. Results A total of 413 Bulgarian women, with a mean age of 34.3 (±5.1), participated in the study. Almost all women (91.3%) reported that their children had a primary care provider. The mean time to reach the GP/pediatrician’s office was 16 minutes (95% CI 14.6 - 16.7), longest for residents of small towns and villages (21 minutes), p = 0.004. Parents from small towns (including villages) were six times more likely to experience financial difficulties related to their children’s healthcare services compared to those from the capital city (p = 0.047), as well as parents with low-income (p = 0.031). Emergency healthcare was the most demanded service by families with children under 7 years old, possibly due to its free availability. Parents with secondary education and from small towns lack access to non-medical health-promoting or preventive services such as breastfeeding consultations, speech therapy and others. Conclusions Significant financial and geographic disparities in access to early child health services exist in Bulgaria. Key messages • There are serious social health inequalities related to the access to outpatient child health services in Bulgaria. • There is an urgent need for specific child and family health strategy based on the principles of proportionate universalism.

Communication Intervention in South Africa: Advocating for the Listening and Spoken Language Approach

Adhering to Early Hearing Detection and Intervention (EHDI) guidelines is critical for the timely identification and management of infants with hearing impairment. Early intervention specifically focusses on family-centred communication interventions, of which the Listening and Spoken Language–South Africa (LSL-SA) approach is available for children with hearing impairment in South Africa. Studies have evidenced significant benefits for children with hearing impairment enrolled in LSL-SA compared to those enrolled in Traditional Speech-Language Therapy (TSLT), that is, age-equivalent communication outcomes, shorter duration of therapy until discharge, meritorious academic performance and integration into a hearing society. Despite these positive outcomes related to the LSL-SA approach, significant contextual barriers hinder effective implementation nationwide.Contribution: The successful implementation of EHDI guidelines in South Africa hinges on overcoming barriers through tailored healthcare strategies and contextualised delivery. Adapting frameworks such as LSL-SA to fit the local context is crucial for advancing equitable access to EHDI services, positively impacting children with hearing impairment and their families. This article highlights the systemic challenges in South Africa in optimising resources by adopting linguistically appropriate and culturally responsive early intervention approaches to champion hearing healthcare initiatives. Effective collaboration among diverse stakeholders is essential for enhancing the uptake of EHDI guidelines and translating policy into impactful communication interventions. Implementing the core principles of the LSL-SA approach will not only ensure access to this specialised service for suitable candidates but may also alleviate specific barriers to EHDI implementation within TSLT approaches.

A COMPARATIVE STUDY OF CONTINUING PROFESSIONAL DEVELOPMENT FOR SPEECH THERAPISTS AND TEACHERS IN ARMENIA AND BEYOND

The objective of this research project is to present a comprehensive examination of the disparities in continuous professional development (CPD) for speech therapists and teachers. The consequences for service quality and professional standards within these two critical disciplines will be the primary focus of the analysis. As mandated by the regulatory framework, teachers in Armenia, for example, must participate in continuing professional development (CPD) programs to maintain their professional qualifications. On the other hand, speech therapists are not subject to the same responsibilities, which causes significant differences between the two professions in terms of the development of skills and the ongoing of their education. This study compares the consequences of several continuing professional development requirements, shared professional practices, and relevant government laws. A critical analysis of the quantitative and qualitative pros and cons of mandating continuing professional development (CPD) for speech therapists is conducted. To support this review, empirical evidence has been gathered via interviews with important stakeholders and a comprehensive study of the present accessible knowledge. These findings highlight the urgent need for a more organized and coherent continuous professional development (CPD) framework particularly designed for speech therapists, that conforms with the professional development policies set for teachers, and that is more consistent. Additionally, this research offers specific recommendations that are designed to enhance legislative structures to increase the opportunities for continuing professional development (CPD) in both professions. The suggested projects are meant to improve the quality of services and professional knowledge in speech therapy as well as to guarantee that every professional working in Armenian educational and therapeutic environments satisfies high criteria of competence. The communities they serve will eventually gain from this. This will be achieved by fostering a culture of ongoing professional development.

EFFECTIVE APPROACHES TO ENHANCING CONNECTED SPEECH IN PREOPERATIVE CHILDREN WITH OPEN ORGANIC RHINOLALIA

Children with open organic rhinolalia, a condition often resulting from structural anomalies such as cleft palate, face unique challenges in speech development, particularly in the preoperative period. This article examines the methods, techniques, and strategies used to improve connected speech in these children before undergoing surgical intervention. Focusing on evidence-based practices, the article explores various speech therapy approaches, including breathing exercises, articulation drills, and resonance training, all tailored to address the specific needs of children with hypernasal speech. The goal of preoperative speech therapy is not only to prepare children for surgery but also to enhance their overall communication skills by developing more transparent and fluent speech. By reviewing current research and case studies, this article provides insights into effective treatment methods that can be applied in clinical settings to support children with open organic rhinolalia.

KEY ASPECTS OF SPEECH THERAPY FOR VOICE RESTORATION IN CASES OF VOCAL CORD DYSFUNCTION AND FAILURE

This article investigates the underlying causes of vocal fold and hypo dissolution and their pathological impact on the acoustic properties of the voice and respiratory function. It delineates the characteristic symptoms experienced by individuals with vocal fold dysfunction, highlighting the adverse effects on voice quality and communication challenges. It addresses complications associated with vocal fold dysfunction and outlines a structured speech therapy approach to mitigate voice disorders. The therapeutic approach emphasizes integrating interdisciplinary techniques to achieve optimal corrective outcomes. Given its relevance, this issue holds significant importance in both healthcare and pedagogical contexts, particularly in treating and rehabilitating individuals with vocal fold dysfunction.

Personalized, performance-specific speech intervention in children with a cleft palate: A systematic review protocol.

The provision of speech intervention in children requires personalized, child-tailored approaches. Different speech-intervention approaches exist to eliminate cleft-related speech errors in children with a cleft palate. However, it is unclear what approach works best for the subtypes of cleft-related speech errors. To describe a protocol for a systematic review that provides speech-language pathologists with the current literature concerning more individualized speech intervention in children with a cleft palate. A systematic literature review was performed following the preferred reporting items for systematic reviews and meta-analyses. Two speech-language pathologists with clinical and scientific experience in cleft speech searched different electronic databases for relevant studies. No limit regarding publication date was set. Specific eligibility criteria were defined and used to include or exclude the studies. All included studies were evaluated with a risk-of-bias assessment tool and levels of evidence. Relevant data were extracted from the studies (study design, study population characteristics, intervention characteristics and outcome characteristics) and a narrative synthesis was performed. The findings of this systematic review will significantly contribute to the evidence on personalized speech intervention in children with a cleft palate. The study will inform speech-language pathologists on the possibilities to tailor treatment plans more to the specific subtype of cleft-related speech errors. The planned systematic review also makes recommendations for further cleft speech intervention research. What is already known on this subject At present, there is growing evidence for different speech therapy approaches in children with a cleft palate. Despite the recognized need for personalized, child-tailored therapy, there is no consensus on the best speech therapy approach per different subtype of compensatory cleft speech characteristic. What this study adds to the existing knowledge This paper provides a protocol for a systematic literature review of this topic. Specifically, it searches the literature for the use of personalized speech therapy approaches in children with different subtypes of compensatory cleft speech characteristics. What are the practical and clinical implications of this work? The systematic literature review provides speech-language pathologists with the current literature concerning personalized, performance-specific speech intervention in children with a cleft palate. Besides, the results will support therapy decision-making in children with a cleft palate in different speech-related clinical contexts.

Progress Toward Estimating the Minimal Clinically Important Difference of Intelligibility: A Crowdsourced Perceptual Experiment.

The purpose of the current study was to estimate the minimal clinically important difference (MCID) of sentence intelligibility in control speakers and in speakers with dysarthria due to multiple sclerosis (MS) and Parkinson's disease (PD). Sixteen control speakers, 16 speakers with MS, and 16 speakers with PD were audio-recorded reading aloud sentences in habitual, clear, fast, loud, and slow speaking conditions. Two hundred forty nonexpert crowdsourced listeners heard paired conditions of the same sentence content from a speaker and indicated if one condition was more understandable than another. Listeners then used the Global Ratings of Change (GROC) Scale to indicate how much more understandable that condition was than the other. Listener ratings were compared with objective intelligibility scores obtained previously via orthographic transcriptions from nonexpert listeners. Receiver operating characteristic (ROC) curves and average magnitude of intelligibility difference per level of the GROC Scale were evaluated to determine the sensitivity, specificity, and accuracy of potential cutoff scores in intelligibility for establishing thresholds of important change. MCIDs derived from the ROC curves were invalid. However, the average magnitude of intelligibility difference derived valid and useful thresholds. The MCID of intelligibility was determined to be about 7% for a small amount of difference and about 15% for a large amount of difference. This work demonstrates the feasibility of the novel experimental paradigm for collecting crowdsourced perceptual data to estimate MCIDs. Results provide empirical evidence that clinical tools for the perception of intelligibility by nonexpert listeners could consist of three categories, which emerged from the data ("no difference," "a little bit of difference," "a lot of difference"). The current work is a critical step toward development of a universal language with which to evaluate changes in intelligibility as a result of neurological injury, disease progression, and speech-language therapy.

Development and evaluation of an online professional development course to support delivery of tiered school-based rehabilitation services

Purpose The Facilitating Integration of Rehabilitation Services Through Training (FIRST) Course provides online professional development on tiered service delivery models for rehabilitation professionals working in education settings. Created by content and e-learning experts, this study describes our use of the Analysis, Design, Development, Implementation, Evaluation (ADDIE) instructional design model and the Successive Approximation Model (SAM) to develop, implement, and evaluate the FIRST Course, and reports the findings of an initial program evaluation. Method Rehabilitation professionals who completed the FIRST Course were invited to complete a cross-sectional survey to evaluate its utility. Results Between May 1, 2020, and August 11, 2023, 314 occupational therapists, 54 physiotherapists, and 170 speech-language pathologists completed the online course and survey. Respondents perceived the FIRST Course content to be relevant to their practice and to meet their learning needs regarding tiered services in education settings. Most respondents viewed the course positively and would recommend it to colleagues. More experienced respondents suggested a need for training on tiered service delivery models beyond an introductory level. Conclusions The ADDIE and SAM instructional design models were successfully applied to develop, implement, and evaluate online professional development for school-based rehabilitation professionals who wish to learn about tiered service delivery models.

Engaging with injustices: progressively re-orienting our practices in speech-language pathology toward community development

Engaging with injustices: progressively re-orienting our practices in speech-language pathology toward community development

Investigating morphosyntactic and semantic measures in bilingual Azeri-Persian speaking children aged 5.5 to 6.5 years with and without language impairment

The present study aims to investigate morphosyntactic and semantic measures in bilingual Azeri-Persian-speaking children aged 5.5–6.5 years with and without language impairment. In this cross-sectional study, the bilingual participants were thirty children with language impairment (LI) and fifteen typically developing children (TD) who were selected from nurseries and Speech therapy clinics. The language samples were collected through story-telling in Azeri and Persian languages, separately. The linguistic analysis was done based on morphosyntactic and semantic parameters. The Alberta Language and Development Questionnaire (ALDeQ) parent report questionnaire was completed via interviewing with the parents to differentiate language impairment from language differences. Study findings revealed a significant difference between the morphosyntactic and semantic scores in two groups of bilingual Azeri-Persian speaking LI and TD children (p ˂ 0.05). Also, the results demonstrated no significant relationship between the scores of linguistic scores and age in LI and TD children (p < 0.05). According to the result of the study, morphosyntactic and semantic parameters of language samples in bilingual Azeri-Persian-speaking children could be utilized to provide diagnostic information for speech and language pathologists in LI children among bilingual Azeri-Persian communities.

Toward Process-Oriented, Dimensional Approaches for Diagnosis and Treatment of Speech Sound Disorders in Children: Position Statement and Future Perspectives.

Children with speech sound disorders (SSD) form a heterogeneous group, with respect to severity, etiology, proximal causes, speech error characteristics, and response to treatment. Infants develop speech and language in interaction with neurological maturation and general perceptual, motoric, and cognitive skills in a social-emotional context. After a brief introduction into psycholinguistic models of speech production and levels of causation, in this review article, we present an in-depth overview of mechanisms and processes, and the dynamics thereof, which are crucial in typical speech development. These basic mechanisms and processes are: (a) neurophysiological motor refinement, that is, the maturational articulatory mechanisms that drive babbling and the more differentiated production of larger speech patterns; (b) sensorimotor integration, which forms the steering function from phonetics to phonology; and (c) motor hierarchy and articulatory phonology describing the gestural organization of syllables, which underlie fluent speech production. These dynamics have consequences for the diagnosis and further analysis of SSD in children. We argue that current diagnostic classification systems do not do justice to the multilevel, multifactorial, and interactive character of the underlying mechanisms and processes. This is illustrated by a recent Dutch study yielding distinct performance profiles among children with SSD, which allows for a dimensional interpretation of underlying processing deficits. Analyses of mainstream treatments with respect to the treatment goals and the speech mechanisms addressed show that treatment programs are quite transparent in their aims and approach and how they contribute to remediating specific deficits or mechanisms. Recent studies into clinical reasoning reveal that the clinical challenge for speech-language pathologists is how to select the most appropriate treatment at the most appropriate time for each individual child with SSD. We argue that a process-oriented approach has merits as compared to categorical diagnostics as a toolbox to aid in the interpretation of the speech profile in terms of underlying deficits and to connect these to a specific intervention approach and treatment target.

Supporting adherence to a home practice reading program using self-monitoring in persons with aphasia: a single case experimental design study

ABSTRACT Background Impairments in reading comprehension impact participation in daily activities for persons with aphasia. Home practice programs can be used by speech-language pathologists to extend treatment by providing additional practice to support recovery. However, adherence to home programs is often low and factors that enhance adherence to home programs are poorly understood. Aims We sought to examine if using self-monitoring practice with an aphasia-friendly logbook and a timer is an effective mechanism to support home program adherence and to explore the perception of this technique by individuals with aphasia. Methods & procedures This non-concurrent multiple baseline single case experimental design was completed during the COVID-19 Pandemic. Procedures were completed virtually or in person. If in person, assessments were done in the clinic or in the participant’s home. The participants (n = 6) were at least six months post-stroke, diagnosed with aphasia, and reported interest in practicing reading. There were five males and one female. During the baseline phase, participants received training on a mobile reading comprehension application on an iPad. They were instructed to practice reading 80 minutes seven days a week, and were not provided with self-monitoring supports, but were given a single cue card that indicated the practice expectation. The number of data points in the baseline phase was at least five and increased across participants. At the end of baseline, participants received training on the use of a timer and an aphasia-friendly logbook for self-monitoring minutes of practice. They were instructed to continue practicing for 80 minutes every day. In both phases, participants received weekly check-ins to ensure the technology was working. Outcomes & results The primary outcome measures were minutes of practice and percent adherence. Three out of the six participants demonstrated an effect with the self-monitoring intervention with more minutes of practice or greater percent adherence during the intervention phase. Responders typically had higher self-efficacy for exercise scores and a shorter baseline phase. Three participants did not demonstrate an effect of the self-monitoring intervention. The logbook was reported as one of the two most helpful features of the intervention by all the participants with weekly technology check-ins and iPad training as the least helpful elements. Conclusions Self-monitoring with an aphasia-friendly logbook and timer can support some individuals with aphasia in achieving a greater amount of home program practice. Additional research with a larger more diverse sample that incorporates timing and self-efficacy for exercise is warranted.

What am I looking at? Graduate student accuracy in identification of anatomic structures/landmarks on swallow imaging.

Speech-language pathologists need to accurately identify structures/landmarks on swallow imaging. Foundational learning begins in graduate training. This study aimed to determine graduate student accuracy at identifying anatomical structures/landmarks during swallow evaluations and to determine if accuracy was predicted by type of imaging, anatomical structure, case type (i.e., normal/abnormal). Researchers recruited first-year graduate speech-language pathology students. Each participant reviewed five static images from lateral radiographic swallow studies and five static images from endoscopic swallow studies across 10 cases. Participants identified key anatomic structures and landmarks by clicking on the structure/landmark within a web-based platform. Two experienced speech-language pathologists reviewed and coded participant responses for accuracy. Sixteen graduate speech-language pathology students participated in a within-subjects design. Overall participant accuracy in identification of structure/landmarks was 69% (range 46%-88%). Binomial logistic regression was performed to study the effects of anatomical structure, case type (i.e., normal/abnormal), and image type on likelihood of participant accuracy in identifying anatomical structures (X2(4) = 143.65, p < 0.001). Only anatomical structure was statistically significant (X2(4) = 187.729, p < 0.001). The model explained 23.2% (Nagelkerke's R squared) of the variance in accuracy and correctly classified 78.4% of cases. Sensitivity was 92.1%, specificity was 47.3%, positive predictive value was 79.84%, and negative predictive value was 72.50%. The area under the ROC curve was 0.754, 95% CI [0.716, 0.791]. Graduate student's ability to correctly identify structures/landmarks overall was lower than desired and accuracy varied per structure. Results have implications for improving graduate student training for identification of structures/landmarks on swallow imaging.

Challenging Case: Family Navigation for Autism Spectrum Disorder.

Leo is a 28-month-old boy from a monolingual Spanish-speaking family who was referred to a developmental-behavioral pediatrics (DBP) clinic for concerns regarding autism. His parents migrated to the United States 8 years ago and currently live and work on a farm. He was born in a US hospital after an uncomplicated pregnancy and has been generally healthy. His parents first became concerned about his development when he was 16 months old. He stopped saying mama/dada in Spanish and started lining up random objects. He had frequent temper tantrums and was difficult to console during unexpected changes in his routine. He screened positive on the Modified Checklist for Autism in Toddlers,Revised with Follow-Up (M-CHAT-R/F) at his 18-month well-child visit, and his pediatrician referred him to the local early intervention program. Calls from the early intervention program to his parents were unanswered. At his 24-month well-child visit, he again screened positive on the M-CHAT-R/F, and his pediatrician placed a referral for a DBP consultation. During the DBP visit at 28 months of age, developmental testing indicated his receptive and expressive language skills to be in the extremely low range, with significant scatter in his cognitive and adaptive skills. Behavioral observations were consistent with parental history and showed differences in social communication and interaction, the presence of repetitive behaviors, and extreme distress with transitions. He was diagnosed with autism spectrum disorder. Recommendations, including referral to early intervention, applied behavior analysis therapy, speech and language therapy, audiology evaluation, and genetic testing, were discussed with his parents through an interpreter. An autism packet, written in Spanish, with detailed information about autism and community resources was given to the family. By the time of a follow-up DBP visit 6 months later, Leo had not started on any early intervention or therapeutic services. Where do you go from here?

Readability of Patient-Reported Outcome Measures Used in Voice Disorders

ObjectivesThis study aims to evaluate Turkish patient-reported outcome measures (PROM) used in voice disorders using different readability formulas and to examine the relationship between text-based features and readability values. Study DesignA search was conducted to identify published Turkish PRO questionnaires related to dysphonia that are completed by patients. MethodsSearch was conducted to identify published PROM related to dysphonia that are completed by patients in a self-administered format. Reading grade levels were analyzed for voice-related PROM using the Ateşman readability and the Bezirci-Yılmaz new readability formulas as computed by a readability calculations software package. Text-based quantitative features are obtained. Descriptive statistics were also computed across the questionnaires. ResultsA total of 14 PROMs were found. In the analysis, the mean of the Ateşman readability values of the PROM was calculated as 70.66 (±5.55). This value is defined as 'easy', according to the Ateşman readability measures. The average Bezirci-Yılmaz new readability value is 6,03 (±1,07). This value corresponds to the 6th grade reading level in the Turkish education system. ConclusionsResults show that more than half of the PROMs in the Turkish language have the recommended reading level. PROMs allow healthcare professionals to objectively understand the patient's symptoms, both qualitatively and quantitatively. Therefore, it is critical that patients accurately understand and respond to these outcome measures. This is why developers should consider reading as a testable structure. Speech and language therapists should consider the reading level required to understand a specific PROMs in order to obtain the most useful information for treatment planning and outcome assessments.

Salary Benchmarking for Voice-Specialized Speech-Language Pathologists

Purpose: This study aimed to understand how salaries of voice and upper airway–specialized speech-language pathologists (SLPs) differ from medical SLPs based on prevailing wage data and to give clinicians resources to better negotiate their salary and benefits. Method: A nationwide survey of voice-specialized SLPs was disseminated via various online platforms including American Speech-Language-Hearing Association Special Interest Group 3, Instagram, voice-specialized Facebook groups, and e-mail. Data were collected via REDCap. The survey investigates SLPs' salary, benefits, experience, clinical responsibilities, and profit generated through Current Procedural Terminology codes. Two separate analyses were completed. First, annual salary, as reported by participants, was compared against annual salary, as estimated by prevailing wage data. Second, a multiple regression driver analysis was completed to identify significant predictors of wage level within our sample. Outliers in the sample were removed using the Difference in Fits procedure. Results: A total of 111 participant surveys were included for analysis. Our data demonstrate that, between participant data and prevailing wage data, salaries for voice and upper airway disorders (VUAD) SLPs are significantly higher in the West, Midwest, and Southern regions. There is no significant difference in the Northeast. Several factors proved statistically significant predictors of increased salaries including years of work ( p ≤ .0001), cost of living ( p = .0030), and work in multidisciplinary setting ( p = .0223). Conclusions: As practitioners navigate negotiations for equitable compensation, leveraging localized salary data and emphasizing the value of specialized expertise may prove instrumental. Moreover, advocating for employer-sponsored professional development opportunities and benefits can enhance the overall well-being and professional satisfaction of VUAD SLPs, ensuring optimal delivery of care within this specialized field.