Medical and technological advances have increased the survival rate of children with congenital heart disease, which has led to a deeper understanding of various aspects of their subsequent development. Cardiovascular involvement has a direct impact on feeding, causing sucking and swallowing dysfunctions from birth that can trigger a series of consequences such as malnutrition, dysphagia, and clinical discomfort. This problem not only affects the physiological sphere but also the emotional and family dimensions. This article summarizes key findings in the growing literature on the impact of heart disease on pediatric nutrition and emphasizes the role of speech-language pathology. Further research on this issue is needed to provide greater knowledge that improves the quality of life of these children and their families.

Given limited research on patient perspectives of speech-language pathology (SLP) services in ALS care, this study aimed to assess the satisfaction with, and understanding of, SLP services by people with ALS (pwALS) and to examine the alignment between services received and patient-reported impairments. A cross-sectional survey assessing pwALS' perceptions of SLPs was distributed from October 2024 to January 2025 through electronic mailing lists of relevant professional organizations. A questionnaire examined pwALS' understanding of the SLP role, satisfaction levels, alignment between patient-reported impairments and SLP interventions, and perceived gaps in care. Responses were analyzed using descriptive statistics, with open-ended items analyzed using qualitative analysis. The 81 survey respondents consisted of pwALS (81.5%), caregivers (11.1%), family members (4.9%), and others (2.5%). Overall satisfaction with SLP care was high, though open-ended responses revealed gaps in understanding. Many were unaware of the full scope of SLP services; only 17.3% recognized cognitive evaluation and 8.6% cognitive therapy, compared with speech (77.8%) and swallowing (81.5%) evaluations. Reported services often did not align with communication and swallowing needs, but patients educated about a service were significantly more likely to use it. Overall satisfaction with SLP care was high; however, open-ended responses revealed gaps in understanding, unmet needs, and limited awareness of the full scope of SLP services. This misalignment highlights the need for improved patient and caregiver education regarding the role and timing of SLP involvement to enhance engagement, appropriate service use, and outcomes in ALS care.

Home exercise programs (HEPs) are beneficial for the rehabilitation process, yet adherence remains low (30%-50%). People with aphasia (PWA) face unique challenges due to deficits in language comprehension and/or expression, but research on facilitators and barriers to achieving HEP adherence in this population is limited. This study examines speech-language pathologists' (SLPs') perspectives on factors that facilitate or hinder adherence to HEPs in PWA. A 37-item cross-sectional online survey was administered to SLPs treating PWA. A nonprobability purposive sampling method was used. Likert scale responses were analyzed using descriptive statistics and Spearman rho correlations. Open-ended questions were analyzed for patterns and themes. Of 100 responses, 83 completed surveys were analyzed. Participants were primarily female (~93%) practicing in outpatient settings, with over 21 years of experience. Key facilitators to HEP adherence included motivation (98%), caregiver integration (96%), and incorporating the HEP into daily routines (90%). Moderate positive correlations were found between integrating HEPs into daily routines and perceived relevance (rs = .500, p < .001), as well as between caregiver involvement and HEP integration into daily life (rs = .502, p < .001). Facilitators were categorized as internal (motivation, relevance) and external (family and SLP support). Barriers included internal factors (depression, lack of motivation, severity of deficits) and external factors (limited family support, program difficulty, lack of Spanish language resources). SLPs identified multiple factors influencing HEP adherence. Clinicians should consider these factors when developing HEPs for PWA. https://doi.org/10.23641/asha.32484204.

This article explores allied health professionals in light of persistent and increasing workforce shortages in multiple healthcare roles, along with the growing demand for services, adapting to technological advancements, and evolving patient expectations. While expectations for access, experience, and value increase, the national projections indicate an uneven availability of physicians and nurses. Vanderbilt Health's allied health professionals are a reliable and important asset in the delivery of care and represent a key workforce strategy for health systems. They are also in short supply.Allied health professionals-including respiratory therapists, radiology technologists, rehabilitation therapists, neurodiagnostic technicians, speech language pathologists, medical laboratory scientists, and others-are critical, as physician and nursing shortages increase. Training pipelines, credentialing reforms, and retention strategies can ensure these specialists are adequately resourced to support patient care. Our allied health partners provide extensive patient interaction, supporting care plans when nursing resources are stretched thin.

To develop and validate the SCAMBS rating scale, a multidimensional behavior rating scale assessing five domains-speech, communication and attention, motor,behavioral, and sensory difficulties-in pediatric dental settings for children with and without special healthcare needs. An initial 42-item scale was generated through literature review and expert consultation. Content validation was conducted with eight experts (pediatric dentists, psychologists, speech-language pathologists, occupational therapists, special educators). The refined 34-item version was tested in workshops with 46 dental professionals for clarity and usability. All items achieved strong content validity with Item-CVI scores above 0.78 and a Global Average CVI of 0.95. Domain-specific CVI scores ranged from 0.92 to 0.97. Inter-rater reliability among eight experts yielded a Fleiss' Kappa of 0.765, indicating substantial agreement. The SCAMBS-DRS shows promise as a preliminary, valid, and clinically practical tool for assessing behavioral profiles of children, including those with special healthcare needs, in pediatric dental practice. Provides a structured, multidimensional tool to assess specific behavioral challenges in children during dental visits. Supports improved care for children with and without special healthcare needs by identifying developmental and sensory issues early. Aids in personalized behavior management and clinical decision-making, improving treatment efficiency and outcomes.

[Purpose] To design and develop a new OMNI Exertion Faces Scale (OMNI Faces) that uses universal design criteria to improve acceptability for measuring perceived exertion across age groups, physical activities, and clinical populations. [Methods] The OMNI Faces Scale was developed in collaboration with the original OMNI creator and refined through consultations with educators, speech-language pathologists, clinicians, and feedback from children and adults. Design considerations included universal accessibility, simplified instructions, and alignment with the Heart Rate Reserve method. [Design Features] The OMNI Faces Scale includes five verbal descriptors and five pictorial images to reduce inconsistencies with language, activity-specific visuals, and anchoring among prior versions. The OMNI Faces Scale is non-gendered, non-activity-specific, and has accessible fonts. Instructions were simplified to 71 words relevant for assessing perceived exertion during both aerobic and resistance activities. [Conclusions] The OMNI Faces Scale was designed to provide a versatile and inclusive tool for monitoring exertion in children and adults across a broad range of physical activity applications. Future research will validate its psychometric properties across populations and activity types and explore multilingual adaptations.

To assess the interrater reliability, concurrent validity, and responsiveness of the Children's Eating and Drinking Activity Scale (CEDAS). Interrater reliability was assessed using an online questionnaire completed by speech and language therapists working in hospital and community settings. Participants (n=39) applied CEDAS to 12 vignettes. Interrater reliability was calculated using Krippendorff's alpha (α). Additionally, CEDAS was applied retrospectively to consecutive speech and language therapy referrals at a single hospital (n=85, median age 11 years 2 months, range 1 week-17 years 1 month). Responsiveness was assessed by comparing median CEDAS scores at referral, after initial speech and language therapy assessment, and at discharge. The Functional Status Scale (FSS) feeding domain was used to evaluate concurrent validity. Interrater reliability was excellent (Krippendorff's α=0.927). CEDAS was responsive to change, with expected score increases seen between referral and discharge (Z=-4.37, p < 0.001), and initial assessment and discharge (Z=-3.23, p < 0.001). Strong concurrent validity was established with the FSS (rs=-0.77 to -0.99, p < 0.003). CEDAS demonstrates excellent interrater reliability across clinical settings. It is a responsive tool with established construct validity when used in an acute hospital setting.

Epilepsy is a common neurological condition in children and is often associated with intellectual impairment. However, there is limited information on the intellectual impairment among children with epilepsy in Uganda. This study assessed the prevalence and associated factors of intellectual impairment among children and adolescents with epilepsy attending two national referral hospitals in Uganda. This cross-sectional study included children and adolescents aged 5 to 17 years who had a diagnosis of epilepsy. Intellectual functioning was assessed using the Raven's Progressive Matrices. Logistic regression analysis was performed to determine demographic and clinical factors associated with intellectual impairment. Of 386 participants, 34.7% had intellectual impairment. Older age (adjusted odds ratio [aOR] = 6.94, P = 0.001), being in a special needs school (aOR = 14.50, P = 0.016), not being in school (aOR = 26.01, P < 0.001), delayed speech (aOR = 3.26, P = 0.030), and anti-seizure medication polypharmacy (aOR = 3.08, P = 0.020) were positively associated with intellectual impairment, while adolescent-onset epilepsy (aOR = 0.05, P = 0.030) was negatively associated. Intellectual impairment is common among Ugandan children and adolescents with epilepsy and is associated with older age, school non-attendance, special-needs school placement, delayed speech, and anti-seizure medication polypharmacy. These findings underscore the need for routine assessment of intellectual functioning and targeted interventions, including academic support, speech therapy, and optimization of treatment regimens.

Oropharyngeal dysphagia is a common and disabling consequence of stroke. Transcranial direct current stimulation (tDCS) has shown potential in promoting swallowing recovery, although evidence remains limited. To determine whether bilateral anodal tDCS combined with intensive speech-language therapy (SLT) improves swallowing outcomes compared with sham stimulation in patients with post-stroke dysphagia. Exploratory analyses examined the influence of treatment phase, sex, lesion site, and baseline severity. This multicenter, randomized, double-blind, sham-controlled trial enrolled patients with supratentorial or infratentorial ischemic stroke and oropharyngeal dysphagia. Participants received either bilateral anodal tDCS or sham stimulation (1.5 mA, 20 min/day, 5 days/week for 2 weeks) combined with intensive SLT over 6 weeks. Swallowing outcomes were assessed at baseline, 2 weeks, and 6 weeks using the Dysphagia Outcome and Severity Scale (DOSS, primary outcome), Penetration-Aspiration Scale (PAS), Mann Assessment of Swallowing Ability (MASA), and Swallowing Quality of Life questionnaire (SWAL-QoL). Forty-six patients (24 active, 22 sham) completed the protocol. Both groups showed significant improvement across all outcomes (p < 0.001), with no significant difference between active and sham stimulation. The DOSS was the most sensitive measure, showing sustained improvement over time. Exploratory analyses indicated greater MASA gains with active tDCS in infratentorial strokes (p = 0.04). Correlation analyses showed that greater baseline dysphagia severity was associated with larger functional gains. Intensive SLT was associated with meaningful recovery in post-stroke dysphagia, regardless of stimulation condition. Exploratory findings suggest that bilateral tDCS may confer additional benefit in selected lesion subgroups.

Poor oral health and oropharyngeal dysphagia are modifiable risk factors for aspiration pneumonia. Dental hygienists (DHs) and speech-language pathologists (SLP) provide specialized services to individuals with these issues and may benefit from interdisciplinary knowledge in these areas. The objective of this study was to assess how an interprofessional education (IPE) event influenced students' knowledge and competence in working with individuals at risk for aspiration pneumonia. The current study was a prospective, within-subjects cohort design. Participants included speech-language pathology and dental hygiene students (N = 52). The 3-hr IPE event provided didactic and hands-on training that focused on the modifiable risk factors for aspiration pneumonia. Outcomes were assessed with a content assessment, the Interprofessional Education Collaborative (IPEC) Competency Self-Assessment Tool (Version 3), the Interprofessional Attitudes Scale (IPAS), and written feedback. Students scored significantly higher on the content assessment following the IPE event than at baseline. Ratings on the IPEC Interprofessional Interaction and the Interprofessional Values domains significantly increased following the IPE event, but their IPAS scores did not differ. Three themes emerged in students' written feedback, including: appreciation for an interactive and hands-on educational experience, growth through interprofessional content exploration, and desire for expanded interprofessional opportunities. Students particularly appreciated the hands-on activities (e.g., providing oral care, observing an endoscopy of the upper airway). The IPE event enhanced the interprofessional knowledge and short-term perceived competence of the student clinicians. Long-term interprofessional competence may be best supported by integrating IPE programmatically into academic curricula and assessing outcomes with longitudinal, behavior-based evaluations.

Clinical care for patients who report substantial hearing difficulties despite having little or no hearing loss is a topic of great debate within and beyond audiology. Building on our previous retrospective review of veterans evaluated for auditory processing disorders across the Veterans Health Administration (VHA), the current work presents five such case studies. The goal is to work toward improved patient care by providing a more in-depth view highlighting both strengths and weaknesses of approaches to care for veterans whose hearing difficulties are not explained by hearing loss. Five case studies were selected for review with the goal of identifying individuals with a wide range of etiologies and experiences receiving care for auditory complaints across the VHA. All information provided is taken directly from chart notes available from VHA and Defense Health Agency sources. Etiologies included traumatic brain injury, jet fuel exposure, and nonspecific origins. Some patients experienced well-coordinated care across medical departments, while others experienced repeated barriers and high burdens of self-advocacy while trying to navigate the health care system. Furthermore, differences in the approach of audiologists and speech-language pathologists are highlighted, including differing emphasis on diagnostic tests versus self-report measures and use of top-down versus bottom-up rehabilitation tools. This work highlights several options likely to improve care for veterans with auditory processing deficits, including greater emphasis on addressing patient-specific needs and goals, improved communication and collaboration between audiology and other medical disciplines, and the potential role for auditory device-based rehabilitation options, even among patients with minimal hearing loss.

The Rehabilitation Treatment Specification System (RTSS) is a theory-driven framework for identifying the active ingredients of rehabilitation treatments and was used to create standard labels in voice therapy (RTSS-Voice). The RTSS and RTSS-Voice have high validity, but reliability has not been tested. This study evaluated if RTSS-Voice ingredients can be reliably coded in standard-of-care voice therapy videos and used to identify commonalities and differences in ingredient dosage across five expert voice clinicians from different institutions. Five speech-language pathologists from different institutions videotaped one voice therapy session for 36 patients with vocal hyperfunction. Two trained graduate students coded sessions using four RTSS-Voice ingredients: (a) opportunities to practice voicing, (b) feedback, (c) volition ingredients, and (d) vocal hygiene information. Twelve sessions were double coded for interrater reliability. Practice voicing codes achieved strong to almost perfect reliability (κs: .80-.95), while informational codes achieved moderate-to-strong reliability (κs: .61-.87). All clinicians spent more time on volition ingredients (14-34 min/52.4%-65.7% of the session) compared to practice voicing (3-8 min/6.3%-23.3% of the session) and feedback (3-11 min/10.8%-19.1% of the session). For practice voicing, clinicians incorporated modified airflow and resonance into over 70% of their practice and spent more time in nonspeech and structured speech compared to spontaneous speech practice. Clinicians differed in delivering volitional information and feedback directly versus indirectly. Multiple RTSS-Voice ingredients were reliable across raters, indicating that, with appropriate training, these are readily observable clinician actions that can aid in the study of dosage in voice therapy. The RTSS and RTSS-Voice also identified commonalities and differences in ingredient usage across multiple expert clinicians. Future work could use the RTSS and RTSS-Voice to investigate relationships between variations in therapy ingredients and individual patient outcomes. https://doi.org/10.23641/asha.32785938.

Poststroke aphasia (PSA) significantly impairs language and cognitive functioning, yet few interventions comprehensively address both domains. This study evaluated the efficacy of an intervention combining acupuncture and computer-assisted cognitive rehabilitation using the RehaCom cognitive training system (hereinafter, ACR) on language and nonverbal cognitive function in individuals with PSA. A single-center randomized controlled trial was conducted at a tertiary rehabilitation hospital in Fujian Province, China. Eighty patients with PSA were randomly assigned (1:1) to either the combined-intervention group (ACR plus standard speech and language therapy [SLT]) or the SLT group (SLT only). The intervention consisted of five 30-min sessions per week. Primary and secondary outcomes were assessed using the Western Aphasia Battery-Revised (WAB-R) and the Non-language-based Cognitive Assessment (NLCA) at baseline, Week 4, and Week 12 (post-intervention). Generalized estimating equations were used to evaluate group differences over time. Of the 80 enrolled participants, 71 (88.75%) completed the 12-week intervention. Compared with the SLT group, participants in the combined-intervention group demonstrated significantly greater improvements in the WAB-R Aphasia Quotient at both 4 weeks (B = 5.961, 95% CI [3.765, 8.158], p < .001, Cohen's d = 0.135) and 12 weeks (B = 11.806, 95% CI [8.050, 15.563], p < .001, Cohen's d = 0.460). Significant gains were also observed in WAB-R subdomains, including Spontaneous Speech, Auditory Comprehension, Repetition, and Naming, with small-to-moderate effect sizes. Moreover, the combined-intervention group exhibited substantial improvements in nonverbal cognitive function, as measured by the NLCA, with moderate-to-large effect sizes at both post-intervention points (Cohen's d = 0.434 at 4 weeks; Cohen's d = 0.847 at 12 weeks). The ACR intervention yielded significant and clinically meaningful improvements in both language and cognitive functions in patients with PSA. This multimodal approach represents a promising therapeutic strategy for comprehensive aphasia rehabilitation.

We aimed to provide an overview of measurement instruments available to speech-language pathologists for evaluating acquired non-progressive dysarthria in Arabic-speaking adults; evaluate the availability, clinical utility, and psychometric properties of instruments to inform clinical practice; and examine how closely instruments align with the domains of the International Classification of Functioning, Disability and Health framework to help set priorities for future dysarthria assessment development. The systematic review was guided by PRISMA standards, involving seven databases and manual searching. The process of searching, screening, and data extraction was carried out by two reviewers. The selected studies met predetermined inclusion criteria. Quality of evidence and psychometric data of tools were investigated using: GRADE, MMAT, and COSMIN. Fourteen measurement tools for assessing non-progressive dysarthria in Arabic-speaking adults were identified in the literature. Tools grouped into three categories: Those used in their original format, those which had been translated and adapted, and those specifically developed for Arabic-speaking individuals. Most tools addressed the impairment domain, with limited focus on activity and participation domains. The available tools demonstrated limited clinical availability and insufficient psychometric evidence, highlighting the need for further validation and the development of linguistically and culturally appropriate tools for Arabic-speaking populations, and tools that address all International Classification of Functioning, Disability and Health framework domains.

Modulating sentence comprehension in people with aphasia through anodal tDCS: A double-blind randomized cross-over study.

Speech in Line: A Catholic Ethical Approach in Prioritizing Children with Speech Delay or Elderly Stroke Survivors Amidst the Scarcity of Speech-Language Pathologists in the Philippines

Stuttering affects approximately 1% of adults globally and carries a significant psychosocial burden shaped by public attitudes. Despite growing cross-national evidence using the Public Opinion Survey of Human Attributes–Stuttering (POSHA-S), age-related differences in public attitudes toward stuttering remain relatively underexplored in the Indian context. To address this gap, in the current study, ninety adults from a rural population of Delhi were divided equally into three age groups: young adults (18–35 years), middle-aged adults (36–55 years), and older adults (55+ years). Age group significantly predicted the Overall Stuttering Score and the Beliefs Score. Across both measures, young adults held comparatively least positive attitudes toward people who stutter, middle-aged adults showed demonstrated moderately positive attitudes, and older adults consistently showed the most positive attitudes overall. Bonferroni post-hoc comparisons confirmed that young adults scored significantly lower than older adults on both the Overall Stuttering Score and the Beliefs Score. Significant group differences were also observed for the Traits/Personality, Help From, and Potential components. Bonferroni-adjusted post-hoc comparisons indicated that older adults rated people who stutter more positively on Help From and Potential compared with younger adults, while middle-aged adults rated people who stutter more positively on Traits/Personality compared with younger adults, whereas no significant age-group differences were found for Self-Reactions. These component-level patterns suggest that beliefs about the character, potential, and available support for people who stutter accumulate more positively with age, while immediate behavioral reactions to stuttering remain uniformly negative across all age groups. These findings suggest that public attitudes toward stuttering in Delhi become more positive with increasing age, primarily through differences in the Beliefs domain. Speech-language pathologists (SLPs) have a central role to play in translating these findings into action. As both clinicians and community educators, SLPs are positioned to design and deliver targeted stuttering awareness and destigmatization programs, particularly for young adults who demonstrated the least positive attitudes in the present study. SLPs can advocate for the inclusion of stuttering education in school curriculum, workplace orientation programs, and public health campaigns, and can use instruments such as the POSHA-S to evaluate the effectiveness of such initiatives over time. The results indicate that young adults should be considered a priority target for future stuttering awareness, education, and destigmatization initiatives.

Linguist, Performer, Dialect Coach, Speech Pathologist

Purpose Speech-language pathologists have important opportunities to deliver culturally and linguistically appropriate services for children with complex communication needs. International research has explored services in relation to available augmentative and alternative communication systems and collaboration with families, yet little is known about Australian speech-language pathologists’ practices. The present study explores how Australian speech-language pathologists carry out their work with children with complex communication needs in multilingual families. Method Twenty-three (n = 23) Australian speech-language pathologists participated in semi-structured interviews about their experiences working with children who have complex communication needs in multilingual families. Transcribed interview data were analysed with a thematic analysis approach. Result One of the four main themes is explored in this paper, specifically how speech-language pathologists work to address challenges in providing interventions. Participants described how they work to: (a) Align their own and family expectations, (b) find shared and relevant ways to communicate with families, and (c) tailor resources to child and community needs. Conclusion Findings raise similar challenges to international studies in this area, including the complexity of creating multilingual augmentative and alternative communication systems or adapting existing systems. Participants’ experiences demonstrate both positive achievements or gains towards meeting families’ needs and identify challenges faced.

This study examined the role of inner speech-defined here as the subjective experience of covert lexical access-in naming recovery following semantic feature analysis (SFA) treatment in individuals with aphasia. Specifically, it tested whether baseline inner speech predicted treatment outcome and whether momentary changes in inner speech across the study were associated with naming success. Eighteen individuals with poststroke aphasia completed three pretreatment naming probes, nine SFA treatment sessions targeting 30 individualized items (Treated30), and three posttreatment probes. On each naming trial, participants indicated whether they experienced inner speech prior to responding. The primary hypothesis-that pretreatment inner speech predicts posttreatment naming accuracy for treated items-was tested using logistic mixed-effects models with participant as a random effect. Exploratory analyses used trial-level mixed-effects models to examine whether changes in inner speech, aphasia severity, and psycholinguistic factors (e.g., word frequency, phoneme length) predicted naming outcomes for treated items. Generalization analyses used participant-level models to assess whether inner speech and naming improved for untreated items. Pretreatment inner speech did not predict posttreatment naming success. In contrast, trial-level analyses revealed a strong interaction between treatment and concurrent inner speech: Items were more likely to be named correctly posttreatment when inner speech was present. This effect held after controlling for aphasia severity and psycholinguistic variables. Untreated items showed modest gains, consistent with limited generalization. Baseline inner speech did not predict treatment outcome, but after therapy, participants were much more likely to name an item correctly when they reported inner speech for that item, indicating that inner speech is a dynamic real-time marker of treatment-related lexical access.