Speech Therapy Research Articles

Is collaborative service delivery a choice or a professional obligation? Perspectives of preservice teachers and speech and language pathologists on interprofessional practice

ABSTRACT Interprofessional practice (IPP) between teachers and speech-language pathologists involves sharing knowledge and skills to achieve a common goal of improving child outcomes. Although IPP receives positive support from many disciplines, including early childhood education, there have been multiple challenges cited in the literature. The purpose of this qualitative study was to explore preservice teacher and speech and language pathologists’ perspectives on collaborative service delivery for children with a developmental language delay. The study was completed during two different research phases, collecting survey data from students during spring semesters 2022 and 2023. Student participants were surveyed before and after completing an interprofessional collaborative assignment in class, with each group consisting of at least one preservice teacher and one speech-language pathologist. Results showed fairly consistent themes for both groups of students during both phases of data collection, but also revealed clear gaps in the Interprofessional Education Collaborative (IPEC) Core Competencies. Students were missing competencies and skills such as conflict resolution and well-being, which may have been a result of insufficient training and experiences in the key concepts of collaboration and interprofessional practice.

Communication recovery in the first three months following minor stroke.

Evidence suggests that people with minor stroke can experience multiple post-stroke impairments. This study explored the communication skills of people with minor stroke one week and three months post-stroke. A longitudinal cohort mixed method design was used. Participants completed the Western Aphasia Battery-Revised, Boston Naming Test, La Trobe Communication Questionnaire-Self, Montreal Cognitive Assessment, and the Hospital and Anxiety Depression Scale, along with semi-structured interviews and conversation samples 1 week and 3 months post-stroke. Fourteen participants were recruited. Five experienced aphasia according to Western Aphasia Battery-Revised scores at one week. Boston Naming Test scores improved significantly between one week and three months (p = .020). There were no significant changes in Western Aphasia Battery-Revised, La Trobe Communication Questionnaire-Self, Montreal Cognitive Assessment, or Hospital and Anxiety Depression Scale scores between one week and three months (all p > .05). Word finding difficulties were noted in most participants' conversation samples, but rarely led to conversation breakdowns. Qualitative content analysis revealed eight categories, including communication changes and their impact, the impact of other post-stroke impairments, strategies used, and services received. This study provides further evidence that a subset of people with minor stroke experience post-stroke communication changes. Future research should explore the optimal speech-language pathology support for this potentially under-serviced patient cohort.

Evaluation of a capacity-building program to enhance evidence-based practice of cognitive rehabilitation providers: a pilot study.

Cognitive rehabilitation is a complex and challenging area of brain injury rehabilitation practice, and specialized training programs are needed to upskill practitioners to ensure effective, evidence-based interventions. We developed a cognitive rehabilitation capacity-building program (CogCap) to address this need. The aims of this study were to pilot the CogCap program with a multidisciplinary group of cognitive rehabilitation providers; to evaluate whether it improved participants' self-ratings of knowledge, skills, and confidence in cognitive rehabilitation; and to explore their perceptions and experiences of the program. CogCap was evaluated in a pilot study with 12 cognitive rehabilitation providers, who included occupational therapists, speech pathologists, and psychologists working in brain injury rehabilitation. CogCap components included online self-paced learning modules, workshops, and expert masterclasses completed over a 3-month period. Measures included degree of participation in CogCap components; pre- and post-self-ratings of knowledge, skills, and confidence; and qualitative interviews of CogCap participants about their experience. There were high levels of engagement with the workshops and significant improvements, with large effect sizes in perceived knowledge (d = 0.81, p < 0.05), skills (d = 0.65, p < 0.05), and confidence (d = 1.30, p < 0.01). Four themes were derived from the qualitative interview data: (1) learning through the program, (2) engaging in the program, (3) enhancing practice, and (4) supporting future change. The pilot evaluation provides preliminary evidence of CogCap's effectiveness and acceptability to cognitive rehabilitation providers. Larger scale implementation and evaluation is recommended. http://links.lww.com/IJEBH/A334.

Pediatric feeding academic and post-graduate training experiences of speech-language pathologists and occupational therapists in the United States: differences, preferences, and gaps

Pediatric feeding academic and post-graduate training experiences of speech-language pathologists and occupational therapists in the United States: differences, preferences, and gaps

Why Are They Cheating? A Survey of Speech-Language Pathology Students

Purpose: Academic dishonesty has been a source of concern for universities and colleges for decades; however, there is limited research linking allied health students to cheating behaviors. The purpose of this study was to explore which cheating behaviors occurred most frequently among speech-language pathology students and why. Method: This qualitative study combined a modified version of the International Center for Academic Integrity Student Survey, the Learning Orientation—Grade Orientation Second Edition survey, and three open-ended questions and asked students to self-report cheating behaviors. Requests to participate were sent to accredited programs, with 462 participants starting the survey. Of those, 248 participants completed the survey and 200 completed both the survey and open-ended questions. Frequency analysis, t tests, and regressions were conducted using SPSS to determine frequency of behaviors, reported seriousness of behaviors, and the relationships between variables that led to cheating. Results: Results indicated that 92% of students knew cheating on an exam was serious, yet 26% of students reported engaging in that cheating behavior. Unauthorized collaboration was recognized as moderate cheating, and 43% of students engaged in the behavior. Multiple regression determined grade orientation, perception of the severity of penalty, and disapproval of a close friend all predicted cheating behaviors. Qualitative questions indicated that students say faculty actions lead to the need to cheat and technology for making it easy. Conclusion: Faculty can combat academic dishonesty by modeling academic integrity, reducing the dependence on grades, setting and following a clear academic integrity policy, and developing interpersonal relationships with students.

Communication Outcomes of Children with Hearing Loss: A Comparison of Two Early Intervention Approaches

Background: Early intervention approaches play a critical role in shaping the communication outcomes of children with hearing loss, influencing their language development and overall learning trajectory. Objectives: The main objective of this study was to compare the communication outcomes of children with hearing loss who received Listening and Spoken Language-South Africa (LSL-SA) with those who received Traditional Speech-Language Therapy (TSLT). Methods: A retrospective record review was conducted to gather data on communication outcomes from participants’ speech-language therapy records. Communication outcomes were measured using standardized assessments evaluating speech intelligibility, expressive vocabulary, receptive language, expressive language, audition, and cognitive–linguistic skills. The data were analyzed using quantitative statistics. Key statistical methods included measures to determine associations, identify statistical significance, determine outcomes, and compare differences between the two groups. Results: The study found that children in the LSL-SA group had statistically significant better communication outcomes, with 63% achieving age-appropriate speech intelligibility compared to 45% in the TSLT group (p = 0.046). Similar trends were observed for expressive vocabulary (LSL-SA: 58% vs. TSLT: 39%, p = 0.048) and receptive language (LSL-SA: 60% vs. TSLT: 39%, p = 0.043). Additionally, 66% of children in the LSL-SA group were recommended for mainstream schooling, compared to 39% in the TSLT group (p = 0.0023). These findings highlight the importance of early amplification and structured intervention in improving communication outcomes. The results also emphasize the importance of Early Hearing Detection and Intervention (EHDI) in decreasing the odds of delay in communication outcomes, irrespective of the type of communication approach, although a higher proportion of children in the LSL-SA approach group achieved age-appropriate communication outcomes than those in the TSLT group. Conclusions: This study highlights that communication intervention approaches aligned with the LSL-SA practice promote better communication development and enhance spoken language outcomes in children with hearing loss, facilitating successful transitions to mainstream schooling. Contribution: This study provides contextually relevant evidence for implementing an LSL-SA intervention approach for children with hearing loss. The implications of these findings for clinical practice and future research are discussed in detail.

Approaches to Training Speech-Language Pathologists to Work With People With Aphasia: A Systematic Review.

The aim of this systematic review was to analyze the published research on training approaches for preparing current and future speech-language pathologists (SLPs) to work effectively with people with aphasia (PWA). The review addresses key questions regarding the described training approaches, their key features, research quality, and efficacy. The review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and registered with International Prospective Register of Systematic Reviews (CRD42024453742). The literature search spanned nine databases. Eligibility criteria included peer-reviewed publications in English that reported on training programs involving current or future SLPs working with PWA. Studies were assessed for research quality using the American Speech-Language-Hearing Association's (ASHA's) levels of evidence framework. Narrative synthesis was used to identify key features in the training programs. A total of 920 citations were identified, with 50 studies meeting the inclusion criteria for analysis. Included studies represented a broad range of training approaches, research designs, and research quality. The 50 studies fell into ASHA levels of evidence Ib, IIa, IIb, III, and IV. Statistical meta-analysis was not possible because of variability in research design and outcome measures, but the studies revealed statistically significant findings relevant to the question of what makes training effective for preparing clinicians to work with people with aphasia. The current literature related to training of clinicians to work with PWA is heterogeneous in approach, outcome metrics, and methodological quality. There is evidence supporting several recommendations for training clinicians including integrating direct interactions with PWA during training, combining didactic and experiential learning, and incorporating reflective practices. Overall, the review highlights the need for well-described evidence-based training standards for speech-language pathology students working with PWA. Future research should aim to develop and validate comprehensive training guidelines to improve care quality for individuals with aphasia.

Managing interactional breakdowns with children with ASD: Therapists' practices when directives face challenges in therapeutic interactions.

Effective interventions to promote language competence, cognitive abilities and integrate these skills into daily activities for children with autism spectrum disorder (ASD) often involve providing guidance and training through specific tasks, typically delivered by speech and language therapists through directive interactions. However, engaging children with ASD in such activities is not straightforward and often fraught with challenges. Yet we know very little about how practitioners cope when the interaction breaks down, for example, due to misunderstandings or failures to engage. This study employs a conversation analytic approach to uncover therapists' intricate practices for managing breakdowns in therapeutic interactions. Over 200 hours of naturally occurring interactions between seven Mandarin-speaking children and their therapists were recorded and analysed. Using Conversation Analysis, we identified and analysed 1062 directive turns issued by therapists and subsequent responses of the children. The findings are in three aspects: 1) A crucial and effective premise for increasing engagement and improving the quality of therapeutic interactions lies in recognising, ascribing and utilising the specific interactive modes of children with ASD, including their repeated utterances and prosodic resources. 2) Therapists' strategies are successful when they flexibly address and adapt the format of directives through tailored verbal iteration and embodied solicitation. 3) The importance of timing underscores the increased opportunities to positively influence turn-taking in children with ASD. It is proposed that practitioners can enhance their understanding of children with ASD by incorporating the profiling of interaction into their assessments and interventions, adapting ways to align with the unique patterns of children with ASD.

Poor Oral Health in Adults and Older Adults: A Cross-Sectional Analysis of Videofluoroscopic Swallowing Studies.

To identify oral health variables associated with laryngotracheal aspiration-related outcomes as determined by swallowing during videofluoroscopy in adults and older adults. This cross-sectional study included 225 persons aged 18 years or older who were referred for clinical evaluation and videofluoroscopy examination due to suspected dysphagia. Oral health status assessment comprised self-reported the number of teeth, use and fit of dentures, xerostomia and satisfaction with chewing. The number of teeth and fit of dentures were also assessed clinically by a speech therapist. Videofluoroscopy followed a standardized protocol. The presence and severity of dysphagia was assessed using the O'Neill Swallowing Scale. The Dysphagia Severity and Outcome Scale defined the occurrence of laryngotracheal penetration or aspiration of food. Results were presented as prevalence ratios and 95% confidence intervals. Poisson regressions with robust variance ran on R version 4.2.1. were used to estimate associations with dysphagia and aspiration. In the multivariate models for aspiration, the following factors were associated with the upper arch: Partial dentition with poorly fitted implants, fixed prostheses (single or multiple), or removable partial dentures (PR, 3.45; 95% CI, 1.15-10.41), partial dentition without rehabilitation with prosthesis (PR, 4.05; 95% CI, 1.46-11.22), edentulism with well-fitted conventional total prosthesis (PR, 4.82; 95% CI, 1.29-17.92), and edentulism without complete dentures (PR, 7.22; 95% CI, 2.25-23.10). For the lower arch, associated factors included: Edentulism with poorly fitted conventional total prosthesis (PR, 8.99; 95% CI, 1.85-43.44), partial dentition without prosthesis (PR, 6.76; 95% CI, 1.67-27.84), and edentulism without prosthesis (PR, 8.69; 95% CI, 1.86-40.63). This study highlights the significant association between poor oral health, dysphagia, and aspiration laryngotracheal, underscoring the need for integrated care between speech-language pathology and dentistry. Our findings provide a foundation for future research that incorporates more robust research designs and oral examinations to explore underlying mechanisms explaining the relation between oral health, dysphagia, and aspiration.

Physical rehabilitation for sensorineural hearing loss in childhood: Progress and challenges.

Early intervention for sensorineural hearing loss (SNHL) in childhood is crucial for auditory and language development. In recent years, innovative auditory stimulation techniques and speech therapy strategies, such as middle ear implants, cochlear implants, auditory brainstem implants, and midbrain implants, have provided new avenues for improving patient outcomes. Additionally, basic research advancements in cell reprogramming and regeneration, stem cell therapy, and targeted drug delivery offer promising approaches to meet the individualized needs of children with SNHL. However, many challenges and unresolved issues remain in the treatment of SNHL. This article comments on the case report, which describes a female pediatric patient with SNHL who underwent foot reflexology which led to the normalization of hearing thresholds. Reflexology is considered to have potential benefits in physical rehabilitation, but its efficacy in hearing restoration requires further scientific validation through rigorous clinical trials and large-scale prospective studies.

Examining How U.S.-Educated Students Navigate International Clinical Practice in Audiology and Speech-Language Pathology.

The current qualitative study aimed to explore the experiences and challenges reported by United States (U.S.)-educated international clinicians practicing outside of the U.S. upon graduate degree completion. Identification of strategies for international practice was sought. Nine participants, including seven speech-language pathologists (six women, one man) and two male audiologists practicing in 10 countries, were interviewed. Content analysis was used to systematically structure interview data, and a phenomenological orientation with qualitative analyses was adopted to explore the value and significance of the international practitioners' experiences. Data analysis revealed three overarching themes that emphasized the influence of local context on clinical practice, professional autonomy, and navigating strategies for professional success. These thematic results were supported by several subthemes addressing a range of topics, such as evidence-based practice, colonialism, encroachment, resilience, and self-care. Analysis and interpretation of themes led to specific outcomes, including (a) suggestions for curricular and clinical changes within graduate programs, (b) optimal personal skills and strategies professionals utilize to achieve success during international engagements, and (c) recommendations for universities and professional organizations to enhance graduate personnel preparation of clinicians. Study implications offered recommendations that graduate programs and professional organizations could use to optimize the preparation of the audiology and speech-language pathology workforce internationally. The implications include advising, mentoring, curriculum, service provision coaching, clinical placement, and alumni relations that benefit international graduate degree candidates, departments, and universities. Insights from this study are an invaluable resource for academicians and future graduate students planning to work internationally.

Upholding LGBTQ+ Inclusive Practices in Speech-Language Pathology and Audiology

Purpose: The purpose of this tutorial is to provide ethical considerations for professionals and university clinics working with transgender and gender-diverse (TGD) individuals. Conclusions: With the recent wave of anti-LGBTQ+ (lesbian, gay, bisexual, transgender, and queer) legislation, it is important that the discipline of communication sciences and disorders continue to hold high ethical standards of care and provide affirming services to all clients including TGD clients. The ethical scenarios outlined in this article seek to provide solutions and resources to consider when working with TGD individuals.

Consideration of Intersectionality in the Context of Neurodiversity-Affirming Services for Black Autistic People

Purpose: Neurodiversity-affirming practice is a more inclusive and respectful approach to support for autistic people. By valuing neurodiversity, clinicians can provide more personalized interventions, yet intersectionality needs to be considered. As the neurodiversity movement can be characterized by accommodation of the individual neurodivergent person, as opposed to traditional attempts to force neurodivergent people to adhere to neurotypical standards and ways, this may not always coincide with more collectivist cultures. This viewpoint, from the perspective of a Black autistic social psychology researcher, two Black speech-language pathologists who are caregivers of autistics, and a Black school psychology researcher, is designed to prompt discussion of times when neurodiversity-affirming care might need cultural adjustment. Conclusion: Consideration of intersectionality when implementing services can serve as a guidepost on the path toward care that is both neurodiversity and culturally affirming.

Developing a new aphasia therapy for a virtual world: the virtual enhanced semantic features analysis (VESFA) intervention

Purpose Stroke research Priority Setting Partnerships identified a need for interventions that address wellbeing and communication. This paper outlines the development of a communication and wellbeing intervention for delivery in the virtual world, EVA Park, for people with aphasia called Virtual Elaborated Semantic Feature Analysis. Materials and Methods The Medical Research Council framework for developing complex interventions was followed to combine evidence (literature review), underpinning theory (semantic processing theories, framework for situated language use and learning theories) and involvement with stakeholders (four people with aphasia and three speech and language therapists) in an intervention that addresses word finding, situated language and wellbeing. Results Evidence for the semantic word interventions and situated conversation interventions was synthesised. Theory underpinning the proposed intervention included Hebbian learning, the hub and spokes model of semantic processing, semantic spreading activation theory, the framework for situated language use and learning theories. Stakeholders with aphasia identified intervention content, an acceptable intervention regimen and gave feedback on a taster session. Speech therapists advised how the intervention could be implemented in clinical practice. Conclusion Virtual Elaborated Semantic Feature Analysis is a user-informed, theory-based complex aphasia intervention that is expected to improve word finding, word use in situated conversation and wellbeing.

The Comparison of Quality of Life in Patients with Mild-Moderate Severity of Multiple Sclerosis with and without Dysphagia.

Multiple Sclerosis (MS) is a common chronic disease among young adults. It affects various aspects of Quality of Life (QOL). Dysphagia is a problem associated with neurological damage in MS patients. This study aimed to compare MS patients' QOL with and without dysphagia. This is a cross-sectional study performed on 40 patients with MS (20 with and 20 without dysphagia) selected from the MS Society members of Ahvaz, Iran. Research tools included the Persian version of Dysphagia in Multiple Sclerosis (DYMUS), Mini-Mental State Examination (MMSE), and Multiple Sclerosis Quality of Life-54 (MSQOL-54). The data were analyzed by SPSS software version 22 and the Mann-Whitney test. The results showed a significant difference in QOL score amongst patients with and without dysphagia. The QOL score of patients with dysphagia was significantly lower than patients without dysphagia. The main differences in the subscale of the QOL Index were mental component and physical activity. MS patients with dysphagia had lower QOL than patients without it. The results show that the quality of life of MS patients with dysphagia is lower than the quality of life of MS patients without dysphagia, and this issue includes different physical and mental aspects of the quality of life of these patients. According to the findings of this study, it seems that early referral of patients with MS to speech and language pathologists for the management of swallowing disorders in the early stages of the disease can be very important and help improve the wellbeing of these patients and their families.

An Exploratory Comparison of Attitudes Toward Stuttering and Cluttering of Chinese Practicing Speech and Language Therapists (SLTs) and SLT Students.

This study aimed to compare attitudes toward stuttering and cluttering among speech and language therapists (SLTs) and speech and language therapy students in China and how they differ from those in other countries. It also seeks to explore factors that may influence these attitude differences. We utilized online versions of the Public Opinion Survey of Human Attributes-Stuttering (POSHA-S) and Public Opinion Survey of Human Attributes-Cluttering (POSHA-Cl) instruments to conduct surveys of 54 SLTs and 99 SLT students at six Chinese universities offering speech and language therapy programs. Chinese SLTs had more positive attitudes than did SLT students. For example, rejecting learning and emotional trauma as a cause of stuttering or cluttering (a positive response) was more likely in SLTs than in SLT students. Both groups expressed more positivity about their knowledge sources than the average ratings from international samples. Increased positive exposure opportunities with stuttering or cluttering will likely positively impact on attitudes toward stuttering and cluttering in China. It is crucial for speech and language professionals in China to recognize the widespread misinformation in various sources and actively combat misconceptions about stuttering and cluttering.

Speech-Language Pathologists' Use of Patient-Reported Outcome Measures for Adult Patients With Cognitive-Communication Disorders: A Survey Study

Purpose: Speech-language pathologists (SLPs) primarily assess patients with cognitive-communication disorders using performance-based measures. Patient-reported outcome measures (PROMs) may also prove useful in clinical practice with these populations, as they can capture applied communication constructs with subjective or unobservable elements (e.g., cognitive fatigue). We conducted a survey to gain insight into SLPs' clinical use of PROMs with these populations. Method: Ninety-five SLPs responded to 26 survey items that explored SLPs' (a) current use of PROMs in clinical care for adults with cognitive-communication disorders, (b) needs and barriers related to PROM use in clinical practice, and (c) gaps and needs with respect to the measurement of patient health-related quality of life. A convergent mixed-methods design was used to analyze qualitative and quantitative survey responses. Free-response questions were coded using a conventional content analysis. Results: Forty percent of respondents reported using PROMs with their patients with cognitive-communication disorders, most often for goal setting, followed by assessing treatment effects. SLPs also reported barriers to PROM use with patients with cognitive-communication disorders, such as patient insight deficits and limited time. The identified barriers of poor implementation and dissemination have implications for future research directions. Conclusions: The survey findings suggest that many SLPs do not currently use PROMs with patients who have cognitive-communication disorders, but those who do find them useful for goal setting. Survey findings also indicate several barriers that limit broader adoption of PROMs for this clinical population, which should be addressed through future implementation research and clinical initiatives such as creating PROM education for SLPs.

Socioecological Determinants of Speech Evaluation and Treatment Among Children Who Stutter

Purpose: While there is no cure for stuttering, therapy can help children who stutter (CWS) reduce the adverse effects imposed by stuttering. The Individuals with Disabilities Education Act (IDEA) guarantees “special education and related services” at no cost to all children with disabilities. However, a potential interplay of variables may influence service provision for CWS. Therefore, the purpose of this study was to identify some of the determinants of receiving (a) an evaluation and (b) speech-language therapy (SLT) among a nationally representative sample of CWS. Method: This analysis utilized five waves of the Early Childhood Longitudinal Study, Kindergarten Class of 2010–11—a nationally representative sample of children in the United States attending both full-day and part-day kindergarten in 2010–2011, who were followed through the fifth grade. Over 800 parents reported that their child had a problem with stuttering at least once in the panel. Using a socioecological framework, this study sought to identify the individual-, interpersonal-, and community-level determinants of receiving (a) a communication evaluation and (b) SLT among CWS. Results: Determinants at all three levels were significantly associated with both the likelihood of evaluation and receipt of SLT. Conclusions: Despite the passage of IDEA over 20 years ago, many CWS are not receiving necessary evaluation and therapy services in school. These shortfalls result from determinants at multiple levels making mitigation more challenging. Identification is the first step in resolving such problems, and it is hoped that this project contributes to this discourse.

Interprofessional Education Between Recreational Therapy and Speech-Language Pathology in Long-Term Care

Pediatric patients with chronic pain are at risk for long- term opioid addiction as adults, have limited pediatric treatment options, and commonly experience barriers to developmentally appropriate recreation, leisure, and play opportunities. Interdisciplinary approaches to creating evidence-based therapeutic programs for this population are called for in the literature yet few exist. This qualitative study examines the Kids B.E.A.R. Pain Protocol, an interdisciplinary approach created by professionals in public health, child psychology, and recreational therapy healthcare fields. The major overarching theme of psychosocial support emerged after analyzing semi-structured interviews with adolescent patients, parents, and staff associated with the Kids B.E.A.R. Pain Protocol. Four corresponding subthemes were present including: 1) enhanced social networks, 2) giving and receiving support, 3) inclusive and normalizing nature of the intervention, and 4) social comparisons with similar others. Preliminary qualitative evidence supports the continued implementation of this interdisciplinary Kids B.E.A.R. Pain Protocol with future research needed to better understand the generalizability of a wider patient population.

Harmonizing Identities: A Scoping Review on Voice and Communication Supports and Challenges for Autistic Trans and Gender Diverse Individuals.

Autistic trans and gender diverse (TGD) individuals face unique voice and communication challenges compounded by minority stressors, impacting wellbeing and access to care. Speech pathologists are crucial in providing gender-affirming and neurodiversity-affirming support; however, guidance for working with this intersectional population remains limited. This scoping review mapped current knowledge on voice and communication challenges, identifies available supports, and demonstrates the limitations of existing guidance for speech pathologists. This review draws on 40 sources, including 29 peer-reviewed articles, 8 clinical guidelines, 2 books, and 1 position statement, identified through comprehensive searches of databases such as CINAHL, ERIC, Medline, APA PsycINFO, and grey literature in May 2024. Findings indicated that 96.8% of identified challenges pertained to communication, while fewer (3.2%) focused on voice-specific issues. Similarly, supports primarily addressed communication (91.3%), with 8.7% targeting voice needs. Communication challenges included barriers faced by autistic TGD individuals and those interacting with them, including healthcare professionals, peers, and family. Supports were identified as strategies and resources to enhance service delivery and client wellbeing, such as using visual aids or offering multiple communication options. However, significant gaps remain in addressing the unique voice and communication needs of this population, particularly regarding voice dysphoria, camouflaging versus identity disclosure, and communication within healthcare settings. Autistic TGD individuals represent a unique population whose needs are not sufficiently addressed by current guidance. This review highlights significant gaps in research and clinical practice and calls for improved clinical guidelines and specialized training for speech pathologists to enhance care.