Speech-language Pathology Students Research Articles

Korean speech–language pathologists’ attitudes toward stuttering according to clinical experiences

Negative attitudes toward stuttering and people who stutter (PWS) are found in various groups of people in many regions. However the results of previous studies examining the influence of fluency coursework and clinical certification on the attitudes of speech-language pathologists (SLPs) toward PWS are equivocal. Furthermore, there have been few empirical studies on the attitudes of Korean SLPs toward stuttering. To determine whether the attitudes of Korean SLPs and speech-language pathology students toward stuttering would be different according to the status of clinical certification, stuttering coursework completion and clinical practicum in stuttering. Survey data from 37 certified Korean SLPs and 70 undergraduate students majoring in speech-language pathology were analysed. All the participants completed the modified Clinician Attitudes Toward Stuttering (CATS) Inventory. Results showed that the diagnosogenic view was still accepted by many participants. Significant differences were found in seven out of 46 CATS Inventory items according to the certification status. In addition significant differences were also found in three items and one item according to stuttering coursework completion and clinical practicum experience in stuttering, respectively. Clinical and educational experience appears to have mixed influences on SLPs' and students' attitudes toward stuttering. While SLPs and students may demonstrate more appropriate understanding and knowledge in certain areas of stuttering, they may feel difficulty in their clinical experience, possibly resulting in low self-efficacy.

Speech Tasks and Interrater Reliability in Perceptual Voice Evaluation

The optimal selection of speech task is essential for more reliable perceptual ratings and a better understanding of the perceptual qualities of pathologic voices. Nevertheless, researchers have rarely explored this issue using the GRBAS scale. This study investigates the effect of speech task selection on interrater reliability during perceptual voice assessment. Experimental study. Sixty subjects, 39 dysphonic subjects and 21 normal controls, performed 13 speech tasks including three 5-second sustained vowel sounds (/ɑ/, /i/, and /u/) each at three pitch levels (high, habitual, and low), maximum phonation of the vowel /ɑ/, pitch glide, counting from 1 to 10, and oral reading of the Rainbow Passage. A group of 18 graduate students in speech-language pathology served as perceptual judges and rated the dysphonic severity for the speech samples based on three parameters in the GRBAS scale-Grade, Roughness, and Breathiness. The formalism of the AC1 statistic proposed by Gwet was applied to determine relative reliability between the speech tasks and the raters. The counting task and sustained vowel /ɑ/ in high, habitual, and low registers exhibited the most reproducibility and consequently the highest reliability statistic. The counting task and sustained /ɑ/ phonation are the optimal tasks for perceptual voice judgment in regard to interrater reliability. Future perceptional studies may benefit from this finding to determine the relationship between speech task selection and the validity of any given perceptual rating system in terms of sensitivity and specificity.

The Public Opinion Survey of Human Attributes-Stuttering (POSHA-S) and Bipolar Adjective Scale (BAS): Aspects of validity

PurposeIn order to estimate instrument validity, attitudes toward stuttering measured by the newly developed Public Opinion Survey of Human Attributes-Stuttering (POSHA-S) and the Woods and Williams (1976) semantic differential scale (referred to herein as the Bipolar Adjective Scale [BAS]) are compared in college students on one occasion as well as before and after coursework on fluency disorders. MethodUndergraduate and graduate students (n=321) from four universities filled out online versions of the POSHA-S and BAS. Two-thirds were speech-language pathology (SLP) majors; one-third were students in other majors. A subset of the SLP students (n=35) filled out the two instruments again after 8–13 weeks of coursework on fluency disorders. ResultsCorrelations between all ratings of the POSHA-S and BAS were run for the 321 students. Only 26% of the correlations were statistically significant (R≥±0.129), and the large majority of these reflected small relationships. POSHA-S ratings were correlated with up to 77% of the items of the BAS while BAS items were correlated with up to 45% of the POSHA-S ratings. After coursework on stuttering, students’ attitudes improved on both instruments, but more on the POSHA-S than the BAS. ConclusionsGreater evidence of discriminant validity than convergent validity characterized the POSHA-S and BAS. Both measures showed improved attitudes after fluency disorders coursework, but more so for the POSHA-S, confirming previous reports of construct validity. The POSHA-S taps relevant constructs not included in the BAS, which provide advantages for intracultural, international, and other comparisons of public attitudes toward stuttering.Learning outcomes: The reader will be able to: (1) describe differentiating characteristics of the POSHA-S and BAS as measures of public attitudes toward stuttering, (2) describe the overlap and lack of overlap in the constructs measured by POSHA-S and BAS, (3) describe discriminant versus convergent validity and (4) describe advantages of the POSHA-S and BAS in various types of comparative studies of stuttering attitudes.

Evaluating a Speech-Language Pathology Technology

The creation of new educational strategies based on technology is the essence of telehealth. This innovative learning is an alternative to promote integration and improve the professional practices in speech-language pathology (SLP). The objective of this study was to evaluate an SLP technology designed for distance learning. The survey selected fourth-year SLP students (n=60) from three public universities in the state of São Paulo, Brazil. The experimental group (EG) contained 10 students from each university (n=30), and the remaining students formed the control group (CG). Initially, both groups answered a preprotocol questionnaire, and the EG students received the technology, the recommendations, and the deadline to explore the material. In the second stage all students answered the postprotocol questionnaire in order to evaluate the validity and the learning of the technology contents. The comparison between the CG students showed that their performance worsened in the majority in comparison with the EG students, who showed an improved performance. Therefore, this study concluded that the technology instrument actually responded to the population studied and is recommended to complement traditional teaching.

Board 411 - Research Abstract An Interprofessional Education Approach to the Care of Tracheostomy Patients with Speaking Valves

Introduction/Background Historically, respiratory therapists (RT), speech language pathologists (SLP) and nurses (RN) are trained separately and function independently. Collaboration among these disciplines is essential for optimized patient care and patient communication, particularly for management of tracheostomy patients who need speaking valves. Students learning through interprofessional education (IPE) absorb more than the content, including developing an understanding of professional roles and backgrounds while practicing multi-disciplinary communication.1 Systemic reviews of IPE reflect that it fosters positive interactions and improves attitudes; however, findings are difficult to interpret because projects are diverse, measurement of findings varies, and data is lacking.2 The purpose of this study is to implement an IPE simulation involving RT, SLP and RN students to enhance content mastery related to the interdisciplinary care of tracheostomy patients with speaking valves. Interdisciplinary care is essential for this patient population because optimal levels of patient communication must be balanced with adequate physiologic stability. The following research question is guiding this study: Is there a difference in role understanding and knowledge of clinical indications related to speaking valves, as measured by a pre-test/post-test, after an interprofessional simulation experience with nursing, respiratory therapy and speech language-pathology students? The hypothesis is that there is enhanced understanding of roles and clinical knowledge after an IPE approach using simulation. Upon completion of this simulation, students were able to: 1) understand the roles of RTs, SLPs, and RNs in caring for patients with speaking valves, 2) explain the clinical indications and benefits of speaking valves, 3) demonstrate clinical skills using high fidelity patient simulation and 4) evaluate interdisciplinary collaboration and teamwork. Methods Participants included 90 traditional undergraduate RN students, 22 graduate SLP students and 24 undergraduate RT students. The IPE experience consisted of 3 phases: training, simulation, and debriefing. In the training phase, each class of students viewed a one hour video training module created and presented by Passy-Muir, Inc. Training included anatomical structures, tracheostomy care and indications, benefits and application of speaking valves. For the simulation phase, students were presented with a realistic acute care environment containing a high-fidelity simulator as the patient and standardized patient as the family member. Small groups comprised of students from each discipline worked together in a scenario that included evaluation of patient, tracheostomy care and speaking valve placement, with an emphasis on interprofessional teamwork and patient communication. For the debriefing phase, faculty facilitated student group discussion of their simulation experience. Students were asked to provide reflective evaluation of clinical performance and collaborative care. To measure student understanding of the roles of the disciplines, procedures for speaking valve initiation, and benefits of speaking valves, a pre and post-test was given. An attitudinal survey was used to measure students’ feelings and perceptions toward IPE and IPE using simulation. Results One hundred eleven students participated in the simulation project. An overall net increase of 18% was attained on the knowledge pre and post-test scores with p.<.000. Qualitative statements made by the students indicate the students: increased the value of collaboration within the healthcare system; improved interdisciplinary collaboration/communication skills; increased understanding of the roles of the various healthcare disciplines; and increased knowledge/comfort related to managing a patient with a tracheostomy and speaking valve. Ninety-seven percent of the students wanted to participate in additional interdisciplinary simulations. Conclusion Results of this study support the hypothesis that there is enhanced understanding of roles and knowledge of clinical indications for speaking valves. An implication of this study is that it supports the integration of IPE in health professions education. Qualitative data and Results of the attitudinal survey indicate that students appreciate IPE and support the idea of additional simulations with other disciplines.

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Impact of placement type on the development of clinical competency in speech–language pathology students

Speech-language pathology students gain experience and clinical competency through clinical education placements. However, currently little empirical information exists regarding how competency develops. Existing research about the effectiveness of placement types and models in developing competency is generally descriptive and based on opinions and perceptions. The changing nature of education of speech-language pathology students, diverse student cohorts, and the crisis in finding sufficient clinical education placements mean that establishing the most effective and efficient methods for developing clinical competency in students is needed. To gather empirical information regarding the development of competence in speech-language pathology students; and to determine if growth of competency differs in groups of students completing placements that differ in terms of caseload, intensity and setting. Participants were students in the third year of a four-year undergraduate speech-language pathology degree who completed three clinical placements across the year and were assessed with the COMPASS® competency assessment tool. Competency development for the whole group across the three placements is described. Growth of competency in groups of students completing different placement types is compared. Interval-level data generated from the students' COMPASS® results were subjected to parametric statistical analyses. The whole group of students increased significantly in competency from placement to placement across different placement settings, intensities and client age groups. Groups completing child placements achieved significantly higher growth in competency when compared with the competency growth of students completing adult placements. Growth of competency was not significantly different for students experiencing different intensity of placements, or different placement settings. These results confirm that the competency of speech-language pathology students develops across three clinical placements over a one-year period regardless of placement type or context, indicating that there may be a transfer of learning between placements types. Further research investigating patterns of competency development in speech-language pathology students is warranted to ensure that assumptions used to design clinical learning opportunities are based on valid evidence.

Vocal behaviors of student actors and student speech-language pathologists

Vocal behaviors of student actors and student speech-language pathologists

Stuttering attitudes of students: Professional, intracultural, and international comparisons

PurposeThe study sought to identify major-specific, training, and cultural factors affecting attitudes toward stuttering of speech-language pathology (SLP) students. MethodEight convenience samples of 50 students each from universities in the USA and Poland filled out the Public Opinion Survey of Human Attributes-Stuttering (POSHA–S) in English or Polish, respectively. USA samples included undergraduate and graduate students in SLP majors or non-SLP majors as well as a sample of non-SLP students who were Native Americans. Polish samples included SLP (logopedics), psychology, and mixed majors. ResultsSLP students held more positive attitudes than non-SLP students in both countries. Graduate students held more positive attitudes than undergraduate students in the USA, and this effect was stronger for SLP than for non-SLP students. Native American students’ stuttering attitudes were similar to other American non-SLP students’ attitudes. Polish student attitudes were less positive overall than those of their American student counterparts. ConclusionSLP students’ attitudes toward stuttering are affected by a “halo effect” of being in that major, by specific training in fluency disorders, and by various cultural factors, yet to be clearly understood.Educational objectives: The reader will be able to: (a) describe major factors affecting SLP students’ attitudes toward stuttering; (b) describe similarities and differences in attitudes toward stuttering of students from the USA and Poland; (c) describe similarities and differences in attitudes toward stuttering of Native American students from the USA and non-Native American students.

Preservice Knowledge and Training in Autism Spectrum Disorders

In this study, the author surveyed speech-language pathology students’ knowledge about and training in autism spectrum disorders (ASD). A total of 97 students (74 undergraduates and 23 graduate stu...

An Investigation of Graduate Speech-Language Pathology Students' SLP Clinical Self-Efficacy

An Investigation of Graduate Speech-Language Pathology Students' SLP Clinical Self-Efficacy

The Relationship Between Perceived Supervisory Roles, Working Alliances, and Students’ Self-Efficacy in Speech-Language Pathology Practicum Experiences

Purpose:To examine Anderson’s Continuum Model of Supervision with respect to the field of speech-language pathology, clinical supervision, and the inter-relationships between the Model and perceived supervisory roles, working alliances, and change in students’ self-efficacy (SE).Methods:Graduate students enrolled in initial practicum (N = 117) completed pre-post semester sets of the Generalized Self-Efficacy Scale, Student Profile, Supervisor Rating Form, and Supervisor Working Alliance Inventory. Descriptive demographic information was derived from the Student Profile. Data were analyzed by utilizing a series of parametric statistics for assessing the relationships between variables.Results:Significant positive change in student reports of SE occurred between the beginning and end of the semester (effect size d = 1.547). Relationships were established between change in student SE and supervisor roles (F[5,11]= 8.13, p &lt; 01) and between working alliances and supervisor roles (F[10,220]= 2.56, p &lt;.01). A structural equation model revealed that student demographics had an effect (18.8%) on the relationship between change in students’ SE and independent study constructs.Conclusion:48% of students perceived supervisors to emphasize the Consultant role of clinical supervision; these students also demonstrated greatest perceived change in SE. Although supervision roles within Anderson’s Model relate to effective training of speech-language pathology students, the order in which these roles are presented should not be assumed based on practicum level, but should instead match each student’s individual needs.

Assessment of student competency in a simulated speech-language pathology clinical placement

Clinical education programs in speech-language pathology enable the transition of students’ knowledge and skills from the classroom to the workplace. Simulated clinical learning experiences provide an opportunity to address the competency development of novice students. This study reports on the validation of an assessment tool designed to evaluate speech-language pathology students’ performance in a simulated clinical placement. The Assessment of Foundation Clinical Skills (AFCS) was designed to link to concepts and content of COMPASS®: Competency Assessment in Speech Pathology, a validated assessment of performance in the workplace. It incorporates units and elements of competency relevant to the placement. The validity of the AFCS was statistically investigated using Rasch analysis. Participants were 18 clinical educators and 130 speech-language pathology students undertaking the placement. Preliminary results support the validity of the AFCS as an assessment of foundation clinical skills of students in this simulated clinical placement. All units of competency and the majority of elements were relevant and representative of these skills. The use of a visual analogue scale which included a pre-Novice level to rate students’ performance on units of competency was supported. This research provides guidance for development of quality assessments of performance in simulated placements.

Listeners' Attitudes Toward Children With Voice Problems

To investigate the attitudes of school teachers toward children with voice problems in a Chinese population. Three groups of listeners participated in this study: primary school teachers, speech-language pathology students, and general university students. The participants were required to make attitude judgments on 12 voice samples using a semantic differential scale with 22 bipolar adjective pairs. The voice samples were collected from 6 children with healthy voices and 6 children with dysphonia. The 22 bipolar adjective pairs were intended to cover nonspeech characteristics about the child's personality, social characteristics, and physical appearance. The mean attitude ratings received by children with dysphonic voice were significantly lower (i.e., less favorable) than those received by children with healthy voices in all of the 22 adjective pairs (all ps < .002). The attitude ratings made by the 3 groups of listeners were not significantly different from one another ( ps > .05). To our knowledge, this is the first study in which the authors examine listeners' perception toward children with voice problems in the Chinese population. The results suggest that voice problems in children warrant attention, and their effects on the child should not be underestimated. The findings also highlight the importance of early identification and intervention for children with voice problems.

Perceptions of Racial Privilege in Prospective Speech-Language Pathologists and Audiologists

Awareness of racial disparities and privileges may be regarded as a critical component of cultural competence in speech-language-hearing professionals. In this study, 83 graduate students in speech-language pathology and audiology completed a web-based survey on their perceptions of White privilege. Both qualitative and quantitative results suggest the majority of respondents view racial privileges as minimal in the speech-language-hearing professions; most respondents denied the concept of White privilege or showed minimal awareness. To improve the cultural competence of future speech-language hearing professionals, discussion of racial privilege should be included in training programs and in professional literature.

Performance of speech-language pathology students in problem-based learning tutorials and in clinical practice

The purpose of the study was to identify if performance of speech-language pathology students in problem-based learning (PBL) tutorials could predict subsequent clinical performance evaluated through (a) a non-standardized, custom clinical evaluation form (HKU form) and (b) a standardized competency assessment for speech pathology developed in Australia (COMPASS®). Students’ scores from PBL tutorial performance were correlated with scores in clinical placement on both the HKU form and the COMPASS. Significant correlations were found between students’ PBL tutorial performance (reflective journals and participation in the tutorial process) and their clinical performance (treatment and interpersonal skills) on the HKU clinical evaluation form. Significant correlations were also found between (a) PBL tutorial performance (participation in the tutorial process) and their clinical performance (all generic and occupational competencies, and the overall score) on the COMPASS, (b) PBL tutorial performance (reading forms) and two occupational competencies on the COMPASS, (c) PBL tutorial performance (reflective journals) and four occupational competencies and the overall score on the COMPASS. The results highlighted the need for validating the assessment for the learning process in PBL tutorials with empirical evidence and the advantage of assessing clinical performance through COMPASS in Hong Kong. Tutors, clinical supervisors and students should be given clear behavioral descriptors for expected performance in PBL tutorials and clinical practice at different year levels.

Student Training to Perceptually Assess Severity of Dysphonia Using the Dysphonic Severity Percentage Scale

The goal of the present study was to determine if students can be trained to reliably perceive dysphonia using the Dysphonic Severity Percentage (DSP) scale, a perceptual measure shown to have high interrater reliability when used by speech-language pathologists experienced with voice disorders. Because the DSP scale was found to be useful as a research tool in the measurement of dysphonia, using it to train students to recognize dysphonia can enhance their education as future clinicians and researchers. This method involved having five inexperienced speech-language pathology students listen to voice samples in two conditions (spontaneous speech and paragraph reading) of 10 clients with moderate to severe dysphonia (phonotrauma); the students simultaneously tallied the nondysphonic syllables on written content of the samples to obtain a DSP for both conditions. Because the clients' dysphonias were moderate to severe, and there were many dysphonic syllables, it was more efficient and advantageous for the students' perception and training to tally the nondysphonic syllables, leaving the dysphonic syllables to calculate the DSP. By tallying the nondysphonic syllables, the students were still recognizing which syllables were dysphonic by not choosing them, thus increasing their perception of both normal and disordered syllables. Statistical analysis using the intraclass correlation coefficient revealed high interrater reliability and high correlations among the trained students for both spontaneous speech and paragraph reading, thus indicating similar training experiences and perceptions. This method appeared to be a more quantitative measure of perceptual ratings than current scales, which use general gradations of dysphonic severity. Moreover, the DSPs were similar between the newly trained students and experienced raters for spontaneous speech, indicating that the students could be trained in the direction experienced by voice clinicians. There was, however, a significant difference between the two groups for paragraph reading, which will be discussed. It was concluded that the DSP method was an effective technique to train students to recognize dysphonia.

Concept map analysis in the assessment of speech-language pathology students’ learning in a problem-based learning curriculum: A longitudinal study

The aim of this study was to track students’ critical thinking performance longitudinally through concept map analysis in a problem-based learning (PBL) curriculum. Concept map analysis has been employed in the assessment of students’ critical thinking in medical education. Little is known concerning concept mapping (CM) in speech-language pathology (SLP) education. In this quantitative study, students in a 4-year SLP education program (N = 38) were followed until the completion of a fully-integrated PBL curriculum from Years 1 to 3. Students’ concept maps were analyzed using a tool developed for this study, the Concept Map Assessment Profile (CMAP). There was an increase in concept map scores across the 3 years at the beginning of the academic year. The CM performance over the 3 years predicted 21.0% to 33.6% of variance in three measures of learning outcomes. The CMAP is a reliable measure, with strong inter-rater and intra-rater reliability (r = 0.85 and r = 0.96, respectively). In addition to its use as an assessment tool, the CMAP might be used to facilitate students’ learning as feedback concerning strengths and weaknesses in the development of critical thinking can be provided.

Factors That Enhance English-Speaking Speech-Language Pathologists' Transcription of Cantonese-Speaking Children's Consonants

To investigate speech-language pathology students' ability to identify errors and transcribe typical and atypical speech in Cantonese, a nonnative language. Thirty-three English-speaking speech-language pathology students completed 3 tasks in an experimental within-subjects design. Task 1 (baseline) involved transcribing English words. In Task 2, students transcribed 25 words spoken by a Cantonese adult. An average of 59.1% consonants was transcribed correctly (72.9% when Cantonese-English transfer patterns were allowed). There was higher accuracy on shared English and Cantonese syllable-initial consonants /m,n,f,s,h,j,w,l/ and syllable-final consonants. In Task 3, students identified consonant errors and transcribed 100 words spoken by Cantonese-speaking children under 4 additive conditions: (1) baseline, (2) +adult model, (3) +information about Cantonese phonology, and (4) all variables (2 and 3 were counterbalanced). There was a significant improvement in the students' identification and transcription scores for conditions 2, 3, and 4, with a moderate effect size. Increased skill was not based on listeners' proficiency in speaking another language, perceived transcription skill, musicality, or confidence with multilingual clients. Speech-language pathology students, with no exposure to or specific training in Cantonese, have some skills to identify errors and transcribe Cantonese. Provision of a Cantonese-adult model and information about Cantonese phonology increased students' accuracy in transcribing Cantonese speech.

The confidence of speech-language pathology students regarding communicating with people with aphasia.

BackgroundAphasia is an acquired language disorder that can present a significant barrier to patient involvement in healthcare decisions. Speech-language pathologists (SLPs) are viewed as experts in the field of communication. However, many SLP students do not receive practical training in techniques to communicate with people with aphasia (PWA) until they encounter PWA during clinical education placements.MethodsThis study investigated the confidence and knowledge of SLP students in communicating with PWA prior to clinical placements using a customised questionnaire. Confidence in communicating with people with aphasia was assessed using a 100-point visual analogue scale. Linear, and logistic, regressions were used to examine the association between confidence and age, as well as confidence and course type (graduate-entry masters or undergraduate), respectively. Knowledge of strategies to assist communication with PWA was examined by asking respondents to list specific strategies that could assist communication with PWA.ResultsSLP students were not confident with the prospect of communicating with PWA; reporting a median 29-points (inter-quartile range 17–47) on the visual analogue confidence scale. Only, four (8.2%) of respondents rated their confidence greater than 55 (out of 100). Regression analyses indicated no relationship existed between confidence and students‘ age (p = 0.31, r-squared = 0.02), or confidence and course type (p = 0.22, pseudo r-squared = 0.03). Students displayed limited knowledge about communication strategies. Thematic analysis of strategies revealed four overarching themes; Physical, Verbal Communication, Visual Information and Environmental Changes. While most students identified potential use of resources (such as images and written information), fewer students identified strategies to alter their verbal communication (such as reduced speech rate).ConclusionsSLP students who had received aphasia related theoretical coursework, but not commenced clinical placements with PWA, were not confident in their ability to communicate with PWA. Students may benefit from an educational intervention or curriculum modification to incorporate practical training in effective strategies to communicate with PWA, before they encounter PWA in clinical settings. Ensuring students have confidence and knowledge of potential communication strategies to assist communication with PWA may allow them to focus their learning experiences in more specific clinical domains, such as clinical reasoning, rather than building foundation interpersonal communication skills.