Speech-language Impairment Research Articles

When adults with speech-language impairment meet law enforcement: A qualitative analysis of client experiences

IntroductionMembers of law enforcement and the general public who have limited knowledge of persons with communication impairments (PCI) may misinterpret their communication behaviors. Few studies exist about communication between PCI and law enforcement, and data are lacking about the factors that may influence their interactions. Considering this need, we addressed the following research questions: How will PCI describe their attitudes and experiences related to interacting with law enforcement? What individual characteristics may influence these attitudes and experiences? MethodsIn individual semi-structured interviews, we asked 10 adults with speech-language differences (aphasia, dysarthria, or stuttering) to describe their experiences of interacting with members of law enforcement, the communication strategies they would use when interacting with law enforcement, and what they would like members of law enforcement to know about their communication needs. In qualitative analyses, we generated themes from the data. ResultsThree main themes and four subthemes were evident in participant responses. Participant emotions and communication behavior were affected in complex ways during their interactions with a person of authority in uniform. In this sample of PCI, levels of confidence about communicating with strangers were lower for participants with no visible characteristics versus those who exhibited these signs. The participants recommended communication strategies for use by members of law enforcement. ConclusionsThese findings extend the limited literature on this topic to include factors that appear to influence the attitudes and experiences of PCI during their interactions with law enforcement. In clinical application, speech-language pathologists have an important role to play in assisting clients to practice individualized communication strategies for interactions with law enforcement in various contexts. Further research is needed into the perspectives of PCI and the attitudes and experiences of law enforcement when interacting with PCI.

Relation of Speech-Language Profile and Communication Modality to Participation of Children With Cerebral Palsy.

This study aimed to examine the contribution of speech motor impairment (SMI), language impairment, and communication modality to communicative and overall participation outcomes in school-age children with cerebral palsy (CP). Eighty-one caregivers of children with CP provided information about their child's speech and language skills, communication modality, and participation through a web-based survey. Caregiver responses to two validated scales were used to quantify children's communicative participation and overall participation. Children were classified into four speech-language profile groups and three communication modality groups for comparison, based on caregiver-reported information regarding their child's communication skills. Children with CP who had co-occurring SMI and language impairment had significantly lower levels of communicative participation and involvement in activities overall, compared to children with SMI alone. Among children with SMI, augmentative and alternative communication (AAC) use was associated with greater overall frequency of participation and involvement in life activities. Children with CP who have both SMI and language impairment and those who are nonspeaking communicators should be prioritized early for communication interventions focused on maximizing participation, including consideration of AAC.

Waived English Learners: The Understudied Intersection of English Learner and Special Education Status

Under federal law, parents have the right to decline, or waive, English language support services when their child is identified as an English learner (EL) in school. In this study, we focus on this important subgroup of ELs—referred to as waived ELs—at the understudied intersection of EL status and special education (SPED) status. Using longitudinal statewide Tennessee data from 2010 to 2021, we used discrete-time hazard modeling to explore ELs’ representation in SPED services by their English language service waiver status (i.e., ever-waived EL vs. never-waived EL). Results revealed that ELs’ likelihood of placement into SPED services, and specifically for specific learning disability and speech-language impairment, varied by their English language service waiver status. We describe similarities and differences in the timing and likelihood of placement trends and discuss implications for practice and policy.

Network-based statistics distinguish anomic and Broca's aphasia.

Aphasia is a speech-language impairment commonly caused by damage to the left hemisphere. The neural mechanisms that underpin different types of aphasia and their symptoms are still not fully understood. This study aims to identify differences in resting-state functional connectivity between anomic and Broca's aphasia measured through resting-state functional magnetic resonance imaging (rs-fMRI). We used the network-based statistic (NBS) method, as well as voxel- and connectome-based lesion symptom mapping (V-, CLSM), to identify distinct neural correlates of the anomic and Broca's groups. To control for lesion effect, we included lesion volume as a covariate in both the NBS method and LSM. NBS identified a subnetwork located in the dorsal language stream bilaterally, including supramarginal gyrus, primary sensory, motor, and auditory cortices, and insula. The connections in the subnetwork were weaker in the Broca's group than the anomic group. The properties of the subnetwork were examined through complex network measures, which indicated that regions in right inferior frontal sulcus, right paracentral lobule, and bilateral superior temporal gyrus exhibit intensive interaction. Left superior temporal gyrus, right postcentral gyrus, and left supramarginal gyrus play an important role in information flow and overall communication efficiency. Disruption of this network underlies the constellation of symptoms associated with Broca's aphasia. Whole-brain CLSM did not detect any significant connections, suggesting an advantage of NBS when thousands of connections are considered. However, CLSM identified connections that differentiated Broca's from anomic aphasia when analysis was restricted to a hypothesized network of interest. We identified novel signatures of resting-state brain network differences between groups of individuals with anomic and Broca's aphasia. We identified a subnetwork of connections that statistically differentiated the resting-state brain networks of the two groups, in comparison with standard CLSM results that yielded isolated connections. Network-level analyses are useful tools for the investigation of the neural correlates of language deficits post-stroke.

Eligibility Determinations for Speech and Language Services in U.S. Public Schools: Experiences and Tensions.

The purpose of this study was to examine school speech-language pathologists' (SLPs) experiences regarding students' eligibility for services in public schools within the United States. Fifteen school SLPs participated in online focus groups to examine the complex nature of SLPs' participation within decision-making teams and describe practice experiences in U.S. schools. SLPs worked in one to 10+ schools serving students from pre-K through 12th grade. Data were analyzed using Cultural-Historical Activity Theory (CHAT; Engeström, 2015). School SLPs' practice is impacted by rules, community, and division of labor in schools. Participants discussed the following: culture of the work setting, interaction between team members, desire to assist families and children, knowledge of regulations, evaluation practices, and the impact of poverty, and cultural and linguistic differences. Nine major tensions were identified: need for greater SLP empowerment and advocacy, documentation of educational impact, complexities of students learning English as an additional language, concerns about evaluation data for decision making, SLPs' concerns regarding outcomes of eligibility decision making, overuse of speech-language impairment for students who do not qualify, parents' involvement in decision making, disagreement between team members, and administrations' adherence to rules. Within the schools, the CHAT framework was useful to identify tensions and opportunities for change at the individual and institutional levels, impacting team decision making for eligibility, SLPs' provision of services, and student outcomes. Acknowledgment of tensions and opportunities for change regarding students' eligibility for services may guide public policy; preservice training; and individual, local, and national advocacy.

Telerehabilitation for Stroke: A Personalized Multi-Domain Approach in a Pilot Study.

Stroke, a leading cause of long-term disability worldwide, manifests as motor, speech language, and cognitive impairments, necessitating customized rehabilitation strategies. In this context, telerehabilitation (TR) strategies have emerged as promising solutions. In a multi-center longitudinal pilot study, we explored the effects of a multi-domain TR program, comprising physiotherapy, speech therapy, and neuropsychological treatments. In total, 84 stroke survivors (74 analyzed) received 20 tailored sessions per domain, addressing individual impairments and customized to their specific needs. Positive correlations were found between initial motor function, cognitive status, independence in activities of daily living (ADLs), and motor function improvement after TR. A lower initial health-related quality of life (HRQoL) perception hindered progress, but improved ADL independence and overall health status, and reduced depression correlated with a better QoL. Furthermore, post-treatment improvements were observed in the entire sample in terms of fine motor skills, upper-limb functionality, balance, independence, and cognitive impairment. This multi-modal approach shows promise in enhancing stroke rehabilitation and highlights the potential of TR in addressing the complex needs of stroke survivors through a comprehensive support and interdisciplinary collaboration, personalized for each individual's needs.

Amyloid and Tau PET Positivity in Progressive Agrammatic Aphasia and Apraxia of Speech.

The agrammatic variant of primary progressive aphasia (PAA), primary progressive apraxia of speech (PPAOS), or a combination of both (AOS-PAA) are neurodegenerative disorders characterized by speech-language impairments and together compose the AOS-PAA spectrum disorders. These patients typically have an underlying 4-repeat tauopathy, although they sometimes show evidence of amyloid-β and tau deposition on PET, suggesting Alzheimer's disease (AD). Given the growing number of pharmacologic treatment options for AD, it is important to better understand the incidence of AD pathology in these patients. This study aimed to evaluate the frequency of amyloid-β and tau positivity in AOS-PAA spectrum disorders. Sixty-five patients with AOS-PAA underwent a clinical speech-language battery and PiB PET and flortaucipir PET imaging. Global PiB PET standardized uptake value ratios (SUVRs) and flortaucipir PET SUVRs from the temporal meta region of interest were compared between patient groups. For 19 patients who had died and undergone autopsy, their PET and pathology findings were also compared. The results showed that although roughly half of the patients are positive for at least one biomarker, their clinical symptoms and biomarker status were not related, suggesting that AD is not the primary cause of their neurodegeneration. All but one patient in the autopsy subset had a Braak stage of IV or less, despite four being positive on tau PET imaging. Inclusion criteria for clinical trials should specify clinical presentation or adjust the evaluation of such treatments to be specific to disease diagnosis beyond the presence of certain imaging biomarkers.

Forum Introduction: Promoting Equity in Speech-Language Services With Indigenous Children.

Forum Introduction: Promoting Equity in Speech-Language Services With Indigenous Children.

Procesul de depistare al elevilor cu tulburări de limbaj în Carolina de Sud

This presentation focuses on the process for the initial evaluation of students with speech-language impairment. An initial evaluation involves the use of a variety of assessment tools and strategies to gather relevant functional, developmental, and academic information to assist in determining if the child is eligible for special education services. There is a three-pronged question for eligibility: (1) whether the student is a child with a disability and by reason thereof, (2) has an educational impact and (3) requires direct services. Evaluations must also determine the present levels of academic achievement and functional performance. This shifts the focus of the initial evaluation from the determination of eligibility for services to the determination of what the child needs to enable him/her to learn effectively and to participate and progress in the general education curriculum.

Longitudinal changes in functional connectivity in speech motor networks in apraxia of speech after stroke.

The cerebral substrates of apraxia of speech (AOS) recovery remain unclear. Resting state fMRI post stroke can inform on altered functional connectivity (FC) within cortical language networks. Some initial studies report reduced FC between bilateral premotor cortices in patients with AOS, with lowest FC in patients with the most severe AOS. However, longitudinal FC studies in stroke are lacking. The aims of the present longitudinal study in early post stroke patients with AOS were (i) to compare connectivity strength in AOS patients to that in left hemisphere (LH) lesioned stroke patients without a speech-language impairment, (ii) to investigate the relation between FC and severity of AOS, aphasia and non-verbal oral apraxia (NVOA) and (iii) to investigate longitudinal changes in FC, from the subacute phase to the chronic phase to identify predictors of AOS recovery. Functional connectivity measures and comprehensive speech-language assessments were obtained at 4 weeks and 6 months after stroke in nine patients with AOS after a LH stroke and in six LH lesioned stroke patients without speech-language impairment. Functional connectivity was investigated in a network for speech production: inferior frontal gyrus (IFG), anterior insula (aINS), and ventral premotor cortex (vPMC), all bilaterally to investigate signs of adaptive or maladaptive changes in both hemispheres. Interhemispheric vPMC connectivity was significantly reduced in patients with AOS compared to LH lesioned patients without speech-language impairment. At 6 months, the AOS severity was associated with interhemispheric aINS and vPMC connectivity. Longitudinal changes in FC were found in individuals, whereas no significant longitudinal change in FC was found at the group level. Degree of longitudinal AOS recovery was strongly associated with interhemispheric IFG connectivity strength at 4 weeks. Early interhemispheric IFG connectivity may be a strong predictor of AOS recovery. The results support the importance of interhemispheric vPMC connection in speech motor planning and severity of AOS and suggest that also bilateral aINS connectivity may have an impact on AOS severity. These findings need to be validated in larger cohorts.

Psychometric properties of the Viking Speech Scale-Turkish version for children with cerebral palsy aged 4-18 years based on live and video-based observation.

Speech is the most common method of communication. Video-based clinical communication evaluation is a requirement for children with speech-language impairments living in rural areas, and those who have limited mobility. To determine the validity and reliability of the Turkish version of the Viking Speech Scale (VSS-T) via live and video-based observation for children with cerebral palsy (CP) aged 4-18 years. A total of 142 children (mean age 8.18 ± 3.98 years; 68 female) with CP were included in this study. Their motor, communication, visual and eating-drinking function levels and comorbidities (dental, swallowing, cognitive impairments and epilepsy) were recorded. The Intelligibility in Context Scale (ICS), the Pediatric Evaluation of Disability Inventory-Social Function (PEDI-SF), and the Functional Independence Measure for Children-Communication (WeeFIM-C) were assessed to examine the concurrent validity of the VSS-T. The interrater reliability of the VSS-T was analysed between parents, physical therapists, and speech and language therapists from live and video-based observation. Intra-rater reliability was calculated from ratings made from live and video-based observations taken 3 weeks apart. The VSS-T was strongly related to the ICS (r = -0.830), PEDI-SF (r = -0.819), WeeFIM-C (r = -0.643), other functional classifications (r > 0.432), and the comorbidities (Cramer's V > 0.284, p < 0.001). Good to excellent interrater reliability (κw ≥ 0.838) and intra-rater reliability (intraclass correlation coefficient (ICC) = 0.848-0.995) were found between parents and therapists. Speech and language therapists, physical therapists, and parents can use the VSS-T as a valid and reliable classification system to describe speech intelligibility of 4-18-year-old children with CP. Both live and video-based observations can be used to administer the VSS-T. What is already known on the subject The English version of the VSS has been shown to be a valid and reliable tool used to classify the speech of children with CP aged 4-13 years. The scale can be administered by means of live observation of the child or based on clinicians' notes on the case by parents, SLTs, physiotherapists and paediatricians. What this paper adds to existing knowledge The VSS-T is valid and reliable for children with CP aged 4-18 years. Video-based observation is a suitable method for evaluating the VSS-T levels. The VSS-T has a moderate association with the CFCS. What are the potential or actual clinical implications of this work? The VSS-T is a valid and reliable method of categorizing the severity of motor speech impairment for Turkish children with CP in clinical research studies, registry systems or epidemiological studies. Both experienced and inexperienced therapists can use either live or video-based observation methods to administer the VSS-T. This study extended the validity and reliability of the scale in children with CP aged up to 18 years. The VSS-T is also associated with the Visual Functional Classification System (VFCS), which has been recently developed for describing the visual abilities of children with CP in daily life. In addition, the VSS-T is associated with the presence of dental, swallowing, cognitive problems and epilepsy.

Heritability of Sound Processing Deficits in Autism: Neural Insights

Heritability of Sound Processing Deficits in Autism: Neural Insights

Infection and speech: Disfluency and other speech symptoms in Pediatric Acute-onset Neuropsychiatric Syndrome

IntroductionIn the early 20th century a link between infection and speech disfluency was discussed. Recent reports indicate that PANS (Pediatric Acute-onset Neuropsychiatric Syndrome), and PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) may be associated with a high incidence of speech disfluency. The present study specifically investigates disfluency and other speech symptoms following onset of PANS and PANDAS. Prevalence of previously reported speech related symptoms vocal tics, selective mutism and “baby talk” is included. The present study also aims to explore possible changes in articulation and intelligibility, distress due to speech impairment, and effect of PANS or PANDAS medication on speech symptoms. MethodsA questionnaire was distributed to caregivers of children with diagnosed or suspected PANS or PANDAS. In total 55 individuals in Sweden were included. ResultsOnset of speech disfluency in association with PANS or PANDAS was reported by 54.5% of the caregivers. Most frequent disfluency symptoms were higher speech rate, superfluous verbal behavior, verbal blocks and associated motor symptoms. Previous findings of vocal tics, baby talk and mutistic behavior are supported. The present study also exposed previously unreported symptoms such as impaired articulation, reduced intelligibility, reduced speech production and language impairment. Eleven caregivers reported that medical treatment had a positive effect on speech fluency. ConclusionsA connection between PANS and PANDAS and speech disfluency is supported, and a possible link between infection and disfluency is reactualized. Reported disfluency shares several characteristics with stuttering and cluttering, but the caregivers did not consistently associate it with stuttering. The present study also sheds new light on how symptoms of “baby talk”, selective mutism and vocal tics might be viewed in this population. In all, the results indicate a substantial impact on speech fluency, speech and language in affected children, reducing quality of life.

Speech-Language Pathologists' and Principals' Perceptions of Classroom-Based Services: Similar or Different?

Purpose: Administrative support and accurate perceptions are believed to facilitate the use of speech-language services that are integrated into the classroom (i.e., integrated classroom-based services [ICBS]). The purpose of this study was to compare elementary principals' and speech-language pathologists' (SLPs') perceptions of ICBS in three areas: (a) effectiveness and benefits, (b) impact of the SLP–teacher relationship, and (c) need for administrative support. Method: This study used a web-based survey to investigate Ohio elementary SLPs' and principals' perceptions of ICBS. Demographic information was collected, and participants were asked to state their level of agreement on 17 perception statements using a 5-point Likert scale. Two hundred and ten SLPs and 89 principals participated in the study. Results: Data showed that SLPs and principals held similar perceptions about the overall effectiveness of ICBS, the need for a positive SLP–teacher relationship, the importance of adequate administrative support, and several key benefits. Differences occurred on statements related to targeting speech goals, behavior management, student grouping, and data collection. Conclusions: SLPs and principals generally held more similar than different perceptions about ICBS. Where differences existed, it was recommended that SLPs work with principals to obtain professional development, implement caseload management strategies, and remove barriers that hinder the implementation of ICBS. The efforts may lead to the increased use of ICBS for elementary school–age children with speech-language impairments.

Disability Eligibility Patterns in Head Start Programs: A Comparison of Puerto Rico and the United States

Abstract Population-based research can identify eligibility patterns across e disabilities and cultures, and the Head Start ECLKC gathers relatively controlled data of students in the United States (U.S.) and Puerto Rico, providing an opportunity to directly compare cultures. We compared preschool diagnostic eligibility categories in the U.S. and Puerto Rico for speech/language impairment (SI), autism spectrum disorder (ASD), developmental delay (DD), and intellectual disability (ID) across three years (2016–2018). We observed higher reporting of ASD &amp; SI in Puerto Rico as compared to the U.S., suggesting increased awareness and education towards these diagnoses. While there was higher identification for SI and ASD, there was lower identification for DD and ID in Puerto Rico, suggesting that cultural differences impact how these disabilities are defined and assessed.

The Early Prelinguistic Skills in Iranian Infants and Toddlers

Objectives: The prelinguistic skills which pave the way for language development have always been an area of research in the Speech Therapy field. Although studying these skills is important, there is a study gap among Persian children. Therefore, this study explored prelinguistic skills among a sample of Persian-speaking children aged 6 to 24 months and made a comparison between different age groups. We also studied the effects of gender and family history of speech-language disorders on children’s prelinguistic abilities. Methods: In the present study, 277 mothers of Iranian Persian-speaking children aged 6 to 24 months were asked to fill a research-made checklist that evaluated the prelinguistic skills of their children. This study was cross-sectional and was conducted in Tehran City, Iran, in 2021. Children’s abilities in different age groups were compared using the analysis of variance (ANOVA), Scheffe test, the Kruskal-Wallis test, and the post-hoc test. The differences between the total scores of the two genders were also determined using the Mann-Whitney U test. Results: Comparing the prelinguistic skills in different age groups indicated a statistically significant increase in the scores as children grow up. Children with a positive family history of speech-language disorders scored lower on the checklist than the others (91.03±17.37). Furthermore, there were statistically significant differences between the two genders in developing gesture, vocalization, first words, social interaction, imitation, and play; girls had higher scores. Conclusion: Based on the studies conducted in different countries, prelinguistic skills develop as children grow up; these skills facilitate language acquisition and other social skills. The present study also demonstrated the development of these skills alongside children’s development. This similarity between Persian-speaking children and other children from different cultures and languages, as well as better performance in children with a negative family history of speech-language impairments, confirm the role of genetic factors in children’s development. Moreover, the differences in the development of some prelinguistic skills between girls and boys reveal the impact of various factors, such as social factors, on prelinguistic skills development.

Reciprocal Influence of Mobility and Speech-Language: Advancing Physical Therapy and Speech Therapy Cotreatment and Collaboration for Adults With Neurological Conditions.

The goals of speech therapy and physical therapy are complementary and mutually supportive. Enhanced cotreatment, and collaboration more generally, between physical therapists and speech-language pathologists in the management of adults with neurological conditions can augment task-relevant conditions to improve function.

Professional skills of speech therapist in special education centres of Punjab, Pakistan

Speech-Language Pathologists (SLPs) are responsible for evaluating and treating speech language impairments through professional knowledge and skills, but they also provide other resources such as evaluating and treating swallowing issues, impaired memory, and hearing issues. The present study is about the factors affecting the professional skills of speech therapists in special education centres of Punjab. A cross-sectional research design was used. A total sample of 75 speech therapists was drawn through purposive sampling technique in special educational centres of Punjab included districts of Lahore, Mandibahudin, Sahiwal, Okara, and Shekhupura. There were 68 (90.7%) participants between the ages of 20 to 30. There were 61 (81.3%) male participants and 14 (18.7%) female participants in the study. Results shows that majority of female participants (39.3%) strongly agreed that speech therapist are not sufficient in special educations centres and its caused work burnout among 49.5% female participants but there is no gender association value of p&gt;0.001. 50.8 % females participants agreed training and latest assessment tools are required for desired outcomes in therapeutic sessions. This research concluded that failure to ensure efficient technical skills of speech and language pathologist in special education centres has resulted in a slew of permanent, deadly effects for SLP.

Enhancing Language Services to Native American Children: A Look From the Inside

Enhancing Language Services to Native American Children: A Look From the Inside

Enhancing Culturally and Linguistically Responsive Features of Individualized Education Programs (IEPs) for Speech-Language Pathologists (SLPs).

Individual education programs (IEPs) are the foundation for guiding speech-language pathologists (SLPs) to develop appropriate interventions for culturally and linguistically diverse (CLD) students who qualify for speech-language services under the Individuals with Disabilities Education Act. There is a growing number of CLD students with speech-language impairments who need special attention given to their culture and language. This article highlights key culturally and linguistically responsive features to aid SLPs in developing meaningful IEPs for this diverse group of students.