Speech-language Pathology Graduate Programs Research Articles

Addressing the Gap: A Pilot Study to Improve Graduate Student's Counseling Self-Efficacy Through Online Support Groups for Care Partners of People With Acquired Brain Injuries

Purpose: The purpose of this technical report is to (a) describe the development and pilot testing of a university training initiative for graduate students in speech-language pathology to conduct online support groups for care partners of individuals with acquired brain injuries and (b) share preliminary data on students' self-efficacy in their counseling skills as a result of training. Method: Four graduate students completed an intensive summer counseling training program consisting of two 90-min student orientations to counseling skills and two online support group sessions for care partners of people with acquired brain injuries. A mixed methods analysis of pilot data collected over the summer of 2023 was conducted. Students completed the modified Counselor Activity Self-Efficacy Scales for speech-language pathologists within 1 week of beginning their counseling training and within 1 week after their clinical training experience. Students also submitted a short reflection paper within 24 hr of their two support group sessions to discuss their overall performance within the session and assess their self-efficacy in their counseling skills. Results: Preliminary data evidenced significant pre- to posttraining gains in two primary counseling areas: (a) psychoeducation (i.e., students' ability to provide information to care partners) and (b) empathy when addressing care partners' concerns regarding their loved one's communication disorder. Students' reflection papers illustrated their sense of growth as clinicians and paralleled the findings from their questionnaires. Conclusions: Our preliminary results highlight the importance of providing counseling opportunities for student clinicians in speech-language pathology graduate programs. Our online clinical model offers an example for replicability across universities to foster self-efficacy in students' counseling skills as part of their graduate studies. “Key” ingredients are provided for replication when developing a student-led online support group program for care partners of individuals with acquired brain injuries.

An Exploration of Associations Between Self-Care Practices and Clinical Self-Efficacy in Speech-Language Pathology Graduate Students

Purpose: Previous studies have suggested that many speech-language pathology graduate students experience significant levels of stress throughout their programs. If not effectively mitigated, these stressors could negatively impact students' academic and clinical development. Self-care practices are one potential option that could help address the stressors students encounter throughout their graduate programs. The purpose of this research was to explore potential associations between self-care practices and clinical self-efficacy in speech-language pathology graduate students. Method: This topic was explored using a nonexperimental research design that included descriptive and correlational analyses. A survey that included demographic questions, the Mindful Self-Care Scale–Standard, and a modified version of the Clinical Self-Efficacy Appraisal Inventory was completed by 68 students who were enrolled in a speech-language pathology graduate program. Results: Small positive and significant correlational associations were observed between Mindful Awareness and total Mindful Self-Care Scale–Standard scores and all measured aspects of clinical self-efficacy. The associations between Supportive Relationships and Supportive Structure subscale scores and some aspects of clinical self-efficacy also reached significance. No significant associations were observed between Mindful Relaxation, Physical Care, or Self-Compassion and Purpose subscale scores and any measured domain of clinical self-efficacy. Conclusion: While limitations exist due to the exploratory nature of this study, the results provide an initial examination of associations between self-care practices and clinical self-efficacy.

A Mixed-Methods Analysis of Speech-Language Pathologists' Executive Function Services.

The purpose of this study was to examine school-based speech-language pathologists' (SLPs') implementation of services to address students' executive function (EF) needs, with particular emphasis on the prevalence and characteristics of EF interventions and the factors and barriers that influence service provision for students with EF needs. We applied an explanatory sequential mixed-methods research design, beginning with a quantitative survey followed by a series of qualitative interviews. We analyzed the survey results using descriptive data and binary logistic regressions and used the emergent trends to inform our interview protocol, so that we could explore those trends in greater detail and context. We synthesized our quantitative and qualitative data to evaluate the characteristics of EF interventions and the factors influencing services. Most SLPs reported that they addressed their students' EF needs through some sort of direct or indirect intervention. Direct interventions varied by targeted domain, service delivery setting, and teaching techniques, though most SLPs favored strategy instruction and highly contextualized services. Indirect services included accommodations and consultation. SLPs commonly reported the lack of collaborative support, time, and knowledge as barriers, and most reported that professional development would be helpful to improve their services. Speech-language pathology graduate programs and providers of professional development should be mindful of their role in preparing SLPs to address EF needs, while SLPs may use these results to inform their own practice. Further guidance and research are necessary to elucidate the SLPs' role in mitigating the negative impact of EF challenges on students' education. https://doi.org/10.23641/asha.24101241.

Examining Inclusion in Speech-Language Pathology Graduate Programs Through Minoritized Students' Advice to a Peer

Purpose: Speech-language pathology graduate programs exist within societal structures with uneven distribution of social goods (i.e., tangible and intangible concepts of value). As programs strive to increase inclusion of minoritized students, minoritized students' advice to a peer provides insight into their access to social goods and their use of agency to meet their goals. This study examined minoritized students' peer advice to inform graduate programs. Method: Peer advice about inclusion was solicited from 104 minoritized students in speech-language pathology graduate programs across 28 states as part of a larger survey. One open-ended question specifically asked participants to offer advice to another minoritized student about inclusion in their speech-language pathology graduate program. Qualitative analysis of themes used manual in vivo coding with regular audit memos. Focused analysis on verbs within discourse was also used to determine how the themes related to social goods and student agency. Results: Analysis of themes revealed a graduate school environment where minoritized students could anticipate the loss of social goods (e.g., lack of information, devaluing of identities, and limited relationships). Students used both personal agency to mitigate these losses and collective agency to frame diversity as an asset for clinical practice while supporting each other through a shared understanding of lived experiences. Conclusions: Strategies that may help increase inclusion for minoritized students in speech-language pathology graduate programs are offered. Strategies address students' emotional well-being, education in the service of communities, peer relationships, and valuing diversity.

Graduate Students' Perceived Preparedness and Confidence to Work With Individuals Who Use Augmentative and Alternative Communication.

Previous research shows that practicing speech-language pathologists do not feel confident working with augmentative and alternative communication (AAC) users. Studies examining the content of speech-language pathology graduate programs show that there has been an increase in AAC coursework and experiences offered during graduate training. What has not yet been determined is whether these requirements have influenced students' feelings of preparedness to work with AAC users. The purpose of this study was to examine speech-language pathology master's students' perceived preparedness and confidence to work with AAC users in relation to their educational experiences. A total of 726 graduate students completed a 25-item survey that solicited descriptions of their AAC training, coursework, and clinical experience, as well as their preparedness and confidence to work with AAC users after graduation. Analyses revealed statistically significant relationships between types and number of types of training experiences with feelings of preparedness and confidence. Results indicated that many participants did not feel prepared or confident to work with AAC users after graduation and that those with a greater variety of training experiences felt more prepared and confident to work with AAC users after graduation. The results enhance our understanding of the types and number of types of clinical experiences that might increase students' preparedness and confidence to work with AAC users.

Pediatric Dysphagia: A Look Into the Training Received During Graduate Speech-Language Pathology Programs to Support This Population.

The purpose of this study was to examine academic preparation in pediatric swallowing and feeding, specifically, how speech-language pathology graduate programs were addressing pediatric swallowing and feeding, both academically and clinically, prior to guideline changes and modifications in 2020 due to updates and the global health pandemic. To gain a rounded image of speech-language pathology academic programs, two different methodological approaches were utilized. First, courses from 272 accredited programs were analyzed. Second, survey results from 100 participants were analyzed to investigate clinical clock hours and experiences received during participation in a graduate speech-language pathology academic program. Less than 1% (0.4%) of academic courses analyzed were categorized as pediatric swallowing and feeding. Greater than 90% of participants reported receiving 20 hr or less in pediatric dysphagia, assessment, or treatment. Sixty percent of participants reported not feeling well prepared at all to provide pediatric swallowing and feeding services. There are a growing number of children requiring swallowing and feeding services, a trend that looks to continue its rise. Pediatric dysphagia is a complex area requiring unique knowledge and skills. Academic programs have a responsibility to their students, and the individuals requiring speech-language pathology services, to provide experiences that allow for knowledge and skill development across the entire scope of practice and life span.

Gender Diversity Cultural Responsiveness Education in Speech-Language Pathology Graduate Programs: A Pilot Survey

Purpose: Gender-affirming voice therapy aims to align a person’s voice and communication with their gender identity. Historically, transgender and gender-nonconforming (TGNC) individuals have been marginalized and continue to face significant healthcare disparities. The goal of this research was to examine the self-perceived preparedness of recent speech-language pathology (SLP) graduates for working with TGNC clients. A survey was developed to include both multiple choice and open-ended questions. Topics included graduate-level training on working with TGNC individuals, perceived preparedness to work with this client population, educational resources sought by respondents, and suggested improvements for SLP graduate programs. Thirty recent (since 2016) SLP graduates completed the survey anonymously. Although a majority (83%) of respondents reported that working with TGNC clients was addressed in their graduate education, 66% of respondents felt that instruction time spent on this topic was insufficient or slightly insufficient. Those who had clinical experiences with TGNC clients, or who learned from the perspectives of the TGNC community (e.g., from a guest speaker or video), reported that their graduate education better prepared them to work with TGNC clients. One of the most common recommendations to improve graduate education was to invite TGNC speakers to share their experiences. The majority of respondents identified a need for improvement of gender diversity education in SLP graduate programs. Further research is needed to determine the efficacy of different curricula in increasing the knowledge and skills of SLP graduates specific to TGNC clients to ensure clinical competency and equitable care.

The Utility of Peer-to-Peer Practice for Teaching Speech-Language Pathology Students Transnasal Endoscopy

Introduction: Transnasal flexible endoscopy (TNFE) is necessary for multiple assessments in speech-language pathology (SLP), but it is generally considered an advanced practice technique to be learned during clinical practice. As such, there is no standardized way that it is taught in training programs, leading to a substantial knowledge gap for new graduates. Though peer-to-peer practice has been discussed as an important step in training, it is not clear whether it confers additional benefits above and beyond simulation. This study sought to answer that question in the areas of student confidence, endoscopy speed, and motivation to pursue further TNFE experiences. Methods: Thirty-six SLP graduate students completed TNFE training and one of two practice conditions: simulation only or simulation with additional peer-to-peer practice. Outcome measures included confidence and comfort surveys, intrinsic motivation to complete an additional TNFE experience, and speed of TNFE. Results: No significant differences were found between the two groups for any measure, and consistently low effect sizes indicated there was little difference between groups. Conclusions: These results indicate that teaching TNFE through simulation may provide similar outcomes to peer-to-peer practice during the initial training that an SLP graduate program can provide. This adds to the literature indicating that TNFE simulation is a worthwhile addition to SLP programs.

Graduate Student Clinicians' Perceptions of Child Speech Sound Errors.

Speech-language pathologists (SLPs) rely on auditory perception to form judgments on child speech. This can be challenging for graduate student clinicians with limited clinical experience as they often need to judge children's speech errors using their auditory perception. This study examined how consistently graduate student clinicians used a 3-point perceptual rating scale to judge child speech. Twenty-four graduate student clinicians rated single words produced by children with typically developing speech and language skills and children with speech sound disorders. All participants rated the productions using a 3-point scale, where "2" was an accurate production, "1" was a close approximation, and "0" was an inaccurate production. Ratings were solely based on the auditory signal. These ratings were compared to a consensus rating formed by two experienced SLPs. Graduate student clinicians reached substantial agreement with the expert SLP rating. They reached the highest percentage agreement when rating accurate productions, and the lowest agreement when rating inaccurate productions. Graduate student clinicians reached substantial agreement with expert SLP rating in judging child speech using a 3-point scale when provided with detailed descriptions of each rating category. These results are consistent with previous findings on the role that clinical experience plays in speech error perception tasks and highlight the need for additional listening training in speech-language pathology graduate programs.

Empathy, Post-Stroke Aphasia, and Speech-Language Pathology Students

ABSTRACT Background Empathy is a multidimensional construct potentially important in communicating with an individual with aphasia and for students pursuing a career in speech-language pathology. Unfortunately, little is known about empathy towards someone with aphasia among the general public and speech-language pathologists. Aims The aims of the current study are to explore whether (1) prior knowledge of aphasia predicts state and dispositional empathy after viewing a video of an adult with post-stroke aphasia; (2) state and dispositional empathy differs between a group of individuals seeking a profession in speech-language pathology and those who are not; (3) state and dispositional empathy differ between speech-language pathology undergraduate and graduate students. Methods Two hundred-six participants viewed a video of a male with aphasia engaged in three language tasks and then rated themselves with the Batson Empathy Adjectives (BEA) and the Interpersonal Reactivity Index (IRI; empathic concern and perspective taking). Results State empathy is not influenced by prior knowledge, however, knowledge does predict type of dispositional empathy. Furthermore, state and dispositional empathy does not differ between a group of individuals seeking a profession in speech-language pathology and those who are not seeking this profession. Additionally, state and dispositional empathy do not differ between undergraduate and graduate students in speech-language pathology. Conclusions These findings have implications for programs designed to increase public awareness of post-stroke aphasia as well as speech-language pathology graduate programs.

Graduate Students' Perspectives Toward Telepractice at the COVID-19 Global Pandemic Onset

Purpose The purpose of this article was to describe a cross-sectional research study exploring the perceived knowledge, skills, and attitudes of telepractice service delivery use among speech-language pathology graduate students during the onset of the COVID-19 global pandemic. Method Students' perceived knowledge, skills, and attitudes toward telepractice were examined through an online questionnaire that contained 23 questions, including five demographic questions and 18 Likert scale questions. Participants were 189 graduate students (96% female, 60% first-year graduate students) currently enrolled in speech-language pathology graduate programs. Statistical analyses on students' responses, including independent-samples t tests and correlations, were conducted. Results Only 20% of respondents stated they had provided services via telepractice. Most participants reported slightly more confidence in their perceived skills related to telepractice as compared to their perceived knowledge of telepractice. Students who had prior experience with telepractice were more likely to provide higher ratings compared to those with no experience. Higher ratings of perceived telepractice knowledge and skills were observed for second-year and third-year graduate students compared to first-year students. Positive correlations were observed between students' higher confidence in perceived knowledge and skills related to telepractice and their attitudes toward the service delivery model. Despite positive responses related to perceived telepractice knowledge and skills, the majority of participants reported preferring in-person services over telepractice. Conclusions Taken together, results of this study demonstrate there is an ongoing need for additional telepractice training programs in speech-language pathology focusing on areas in which students feel least comfortable. Telepractice clinical implications and graduate program training recommendations are discussed.

Do No Harm: Graduate Admissions Letters of Recommendation and Unconscious Bias

Purpose: Faculty members commonly write letters of recommendation (LOR) for students. Although letters can be helpful, they may do more harm if they include language that can negatively bias readers. The purpose of this article is to examine LORs written for Black applicants to speech-language pathology graduate programs for the presence of phrases that may bias readers (PBRs). Method: Using data from our program, we analyzed LORs for evidence of bias. Results: Across the 161 LORs, there were 202 instances of PBRs. The most PBRs were grindstone adjectives and doubt raisers/hedges. PBRs were not related to applicants' GPA, undergraduate institution type, or LOR word length. PBRs were related to admission offers. Conclusions: Results suggest a negative impact of PBRs in LORs written for Black applicants. Implications are discussed and recommendations for writing less-biased LORs are provided.

Doing Our Work: Addressing Racially Based Conflict in Communication Sciences and Disorders Programs

Conflicts based on race and ethnicity have been documented in CSD programs. The purpose of this paper is to discuss a racially based conflict that occurred in a speech-language pathology graduate program at a Historically Black University and how the program director, the university’s chief diversity officer, the program faculty, and students worked together to address it. The paper discusses, in detail, the racially based conflict and the specific steps that the program took to address the conflict and to maintain a racially inclusive atmosphere in the program. Details of five specific activities that were used are discussed. The paper concludes with ten suggestions for other programs who may experience racially based conflicts among students.

Three Speech-language Pathology Graduate Programs, One Model: Using Systematic Instruction to Develop Students’ Clinical Decision-making Skills

To prepare graduate students to implement evidence-based practice effectively, educators must integrate instruction on rational clinical decision-making into course curricula. Three faculty members at different universities adopted an educational approach derived from the Rehabilitation Treatment Specification System (RTSS) to teach and assess clinical decision-making in the context of treating acquired cognitive-communication disorders for people with traumatic brain injury. Using treatment theory illustrated in the RTSS, the authors piloted instruction and assessment materials to examine potential usefulness of the approach and effects on student knowledge and confidence in clinical decision-making. The results indicated that the instructional approach effectively bolstered students’ knowledge of and confidence implementing memory-based cognitive-communication intervention. Additionally, using a case-based assessment tool, the authors were able to measure how students modified treatment activities in response to different contextual variables. Implications and suggestions for implementing theory-based instruction in graduate education are discussed.

Infusing Multicultural Instruction: An Experiential Learning Project

The study investigated the effectiveness of a multicultural project implemented for the purpose of infusing multicultural instruction into a graduate level infant language disorders class in a speech-language pathology graduate program. The participants were 24 graduate students who ranged in age from 23-32, 20 were white, 4 were Black. A pretest and posttest survey were implemented along with journal entry thematic analysis to evaluate qualitative changes in learning. The results of the survey indicate that this experiential learning project can promote increased understanding, awareness and confidence in students related to multicultural issues. The journal analysis revealed that students were provided an opportunity to understand the impact of structural inequities related to intersectionality.

Building a Pipeline of Bilingual SLPs to Serve Dual Language Learners: an Inclusive Model of Interprofessional Education

Speech-language pathology graduate programs do not reflect equity across racial and ethnic groups. Training programs must adopt an anti-racist stance and intentionally and strategically plan for equity and inclusion of students and professionals who are Black, Indigenous and Persons of Color (BIPOC). Retention of minoritized students must be supported by inclusion efforts. The authors review systems of support essential to the recruitment and retention of BIPOC students in graduate programs. Through funding support from a grant, the authors developed a model of training bilingual SLP students to work with dual language learners through an inclusive model of interprofessional education. Finally, the authors conclude with a discussion of questions faculty should consider to create institutional change. The authors are hopeful that this article provides SLP programs a best practice framework to build a diverse pipeline of speech-language pathologists better equipped to deliver effective culturally and linguistically responsive interventions for the clients served within our field and across our transdisciplinary work.

Interprofessional Experience for Future Education Professionals: School Psychology and Speech-Language Pathology Students

Educational training programs are tasked with addressing potential barriers to interprofessional practice through experiences that promote interprofessional collaborations. The present study of interprofessional experiences (IPE) had both research and pedagogical purposes. The research purpose was to describe graduate student self-perceptions related to interprofessional teaming/collaboration before and after an IPE involving two educational training programs, school psychology and speech-language pathology. The pedagogical purpose was to convey a detailed description of a case-based IPE offered as a course assignment and offer implementation suggestions. Participants in this course-based IPE were 109 students in the school psychology and speech-language pathology graduate programs at a medium-sized midwestern university over a four-year period. Students in both programs engaged in the IPE as part of a graded class assignment involving case studies. Pre- and post-IPE surveys were used to determine changes in students’ perceptions of their own profession and training, others’ professions, and collaboration and teaming. Results indicated that the perception of students from both programs significantly improved following the IPE. Improved perceptions of collaboration, teaming, and one another’s professions were sustained over four years of implementation. Implications for research, practice, and training are discussed.

Exploring Best–Worst Scaling for Communication Sciences and Disorders

Purpose The primary purpose of this study is to introduce the method of best–worst scaling (BWS) and explore how it can be applied to the field of communication sciences and disorders. Method Two hundred thirty-six participants (156 students and 80 instructors) responded to a survey using BWS to identify the most and least preferred features of a speech-language pathology graduate program. Results were analyzed with Sawtooth Software and best–worst values were transformed into a standardized ratio scale. Results The number one attribute that students were most concerned with when choosing a graduate program was clinical placements followed by financial aid/scholarships/graduate assistant positions, highly ranked/reputation of program, updated resources available in clinic, reputation of professors, elective coursework available in an interest area, proximity to home, research opportunities, completion of an undergraduate degree at the same institution, and, finally, the availability of online courses. Five of the 10 factors were statistically different from the adjacent factor as evidenced by nonoverlapping confidence intervals. The faculty accurately predicted the top three and bottom two attributes but distinguished less between the factors as evidenced by overlapping confidence intervals in eight of the adjacent pairs. Conclusions BWS is able to provide nuanced information relative to the strength of the preference over other types of importance measures. It has many applications in the field of communication sciences and disorders, and this pilot study revealed one way it can be utilized. Knowing what students most desire in a graduate program allows universities to tailor their marketing to highlight the attributes of highest importance to future applicants.

Building Blocks of Knowledge: A Close Look at Prerequisite Coursework for Graduate Programs in Speech-Language Pathology

PurposeThe purposes of this exploratory study were to examine the variability among prerequisite courses required by speech-language pathology graduate programs and to explore how faculty in leadership positions within graduate programs approach decision making about these courses.MethodThis research involved gathering data about the number and type of prerequisite course requirements from American Speech-Language-Hearing Association–accredited speech-language pathology master's degree programs (n= 272) and conducting interviews with a small sample of speech-language pathology department faculty (n= 12).ResultsThe large majority of speech-language pathology graduate programs required the same four general education prerequisite courses. The number of prerequisite courses specific to communication sciences and disorders ranged from three to 17. The rationale for which and how many courses to include as prerequisites varied across programs. Issues related to student preparation and foundation for graduate coursework, the composition of the student body, administrative and logistical factors, and traditions and history of each program influenced how faculty made decisions regarding prerequisites.ConclusionWhile there is not a clear consensus across programs about the number and type of prerequisites necessary to start graduate school in speech-language pathology, most programs feel their ongoing decision making in this area has set up students within their own programs for successful outcomes.

Ageism Among Graduate Students in Communication Sciences and Disorders: A Longitudinal Analysis

Purpose Ageism is a negative bias that results in stereotyping of and discrimination against older individuals and is one of the most institutionalized forms of prejudice in current society. Literature suggests that negative attitudes toward the elderly may have adverse effects, especially in health care settings. The purpose of this investigation was to examine the presence and level of ageism in a group of graduate students enrolled in an accredited speech-language pathology program over a 2-year period, to determine if the degree of ageism differed based on ethnicity, gender, age, or previous experience working with older adults. Method Eighty students of an accredited speech-language pathology graduate program completed the Fraboni Scale of Ageism over a 2-year period at the onset of a course on aging. Students were blinded to the type of assessment they were completing and were anonymous in order to blind the instructor to specific student performance. Demographic data for each protocol were gathered in order to analyze results. Results Data were analyzed using descriptive statistics and analysis of variance calculated for effect size between groups. Results indicated that the level of ageism did not significantly change when grouped by gender, ethnicity, age, or level of experience, though a level of implicit bias was demonstrated through overall participant scores. Conclusions Authors concluded that existing evidence should be used to develop graduate curriculum that encompasses all age groups, especially those aged 65 years and older. Opportunities for experiential learning may provide further benefit to decreasing ageism in graduate students, leading to positive societal change.