Survey Of Speech-language Pathologists Research Articles

A Survey of Speech-Language Pathologists’ Knowledge and Perception About Their Role in Providing Dysphagia Services in India

Purpose: Speech-Language Pathologists (SLPs) are frequently involved in dysphagia services including identification, assessment, diagnosis, and rehabilitation. Understanding of SLPs’ role in dysphagia care has evolved drastically in India over the last decade; however, research and advocacy are still in emerging status. In order to refine dysphagia practice patterns in India, we should understand the current standards. Thus, the present study was conceived to investigate SLPs’ knowledge and perception about their role in providing dysphagia services in India.Methods: A cross-sectional online survey research design was employed. The survey questionnaire comprised of four sections that evaluated SLPs’ demographic characteristics, exposure to dysphagia services, self-perception about their role in the dysphagia rehabilitation team, and knowledge related to assessment and management of individuals with dysphagia. The obtained responses were stored in Google forms and were further analyzed in terms of percentage.Results: A total of 269 SLPs responded to the survey and 59% of the respondent SLPs practicing in India were rendering dysphagia services. Although a majority of the SLPs had adequate knowledge and were aware of their role in the interdisciplinary dysphagia rehabilitation, they lacked opportunities to be a part of the team.Conclusion: The survey clearly identified the trend and issues in dysphagia service delivery by SLPs in the Indian scenario by evaluating their knowledge and skills fundamental to the assessment and management of individuals with dysphagia. This further necessitates a re-examination of the role of SLPs in providing dysphagia services in India in view of establishing standard guidelines and practice patterns.

Developmental Language Disorder Terminology: A Survey of Speech-Language Pathologists' Use and Knowledge.

Developmental language disorder (DLD) is a relatively new, internationally promoted term to describe individuals with language impairments not secondary to a biomedical condition. This study aimed to better understand speech-language pathologists' (SLPs') current level of comfort using DLD terminology and knowledge of DLD in the United States to help SLPs better understand how and why they should consider adopting DLD terminology in their clinical practice. After completing an online presurvey to evaluate current comfort levels in using DLD terminology and current knowledge of DLD, currently practicing SLPs viewed a 45-min prerecorded educational video on DLD. Following this viewing, participants completed a postsurvey nearly identical to the presurvey to measure change in their comfort levels with DLD terminology use and in DLD knowledge. After filtering to remove likely fraudulent responders, we included 77 participants in all analyses. Presurvey Likert scale responses indicated at least some comfort in using DLD terminology. Additionally, presurvey results of true/false DLD knowledge questions revealed high variability in respondents' knowledge of DLD. A McNemar chi-square test indicated statistically significant changes in participants' comfort levels in using DLD terminology from pre- to postsurvey for each question. A paired t test indicated statistically significant changes in DLD knowledge from pre- to postsurvey. Despite some limitations, it was concluded that diffusion efforts, such as educational presentations, are likely to increase SLPs' comfort levels in using DLD terminology and SLPs' knowledge of DLD. https://doi.org/10.23641/asha.22344349.

A Survey of Speech-Language Pathologists' and Teachers' Perceptions of Collaborative Service Delivery.

The purpose of this study was to compare speech-language pathologists' (SLPs) and teachers' perceptions of collaborative service delivery in a school setting. We created a survey for SLPs and teachers that included demographic questions and questions about the use of collaborative service delivery models, identification of collaborative partners, and perceived barriers to collaboration. Eighty-seven SLPs and 77 teachers responded to the survey from 28 states. We analyzed the data using mixed methods. The majority of SLPs reported that they used a combination of collaborative and noncollaborative service delivery models. Teachers also reported that the SLP at their school used collaborative and noncollaborative service delivery models. When asked to report on their collaboration experience generally, teachers rated their experience with collaboration more positively than SLPs. Teachers also were not as likely to identify SLPs as collaborative partners when compared with SLPs who identified teachers as collaborative partners. Finally, teachers and SLPs reported similar barriers to implementing a collaborative service delivery model. However, SLPs identified roles and responsibilities and training on collaboration as barriers to collaboration more than teachers. This study compared SLPs' and teachers' perceptions of collaborative service delivery in schools. The similarities and differences between SLPs and teachers can be used to help facilitate change in the use of collaborative service delivery models.

Telehealth Management of Dysphagia in Adults: A Survey of Speech Language Pathologists' Experiences and Perceptions.

The goal of this study was to explore telehealth use for dysphagia management in response to COVID-19 to understand variables associated with clinician confidence and perceived effectiveness of this service delivery model and determine clinician-perceived benefits and challenges of managing dysphagia via telehealth. Speech-language pathologists (SLPs, n = 235) completed a web-based survey, providing information on demographics, telehealth use during the pandemic, and perspectives on current and future tele-management of dysphagia. Analyses included descriptive statistics to examine usage patterns; logistic regression to determine which variables were associated with telehealth use, clinician confidence, and perceived-effectiveness; and conventional content analysis to analyze responses to open-ended questions. Results revealed a sharp increase in the tele-management of dysphagia during the pandemic. Years of experience with dysphagia management (p = .031) and pre-pandemic use of telehealth (p < .001) were significantly associated with current use patterns. Working in the outpatient setting was associated with greater clinician confidence (p = .003) and perceived effectiveness (p = .007), and use of guidelines (p = .042) was also associated with greater clinician confidence. Key challenges identified included inadequate technological infrastructure, inadequate patient digital literacy, and reimbursement restrictions. Key benefits were treatment continuity, improving access to care, and time savings. The majority (67%) of respondents reported that they would use telehealth in the future. These findings demonstrate SLPs' abilities and desire to expand their practice patterns to include telehealth for dysphagia management. Therefore, clinician training and more research on best practices for assessment and treatment of dysphagia via telehealth is warranted to refine models of care for dysphagia tele-management.

Videofluoroscopy Practice in India: A Survey of Speech-Language Pathologists

Owing to differences in clinical approaches toward videofluoroscopic swallowing studies (VFSS), professional and governing bodies in some countries have implemented guidelines for performing VFSS. However, in India, the establishment of such practice guidelines is in initial stages of acceptance and there are no uniform guidelines. The aim of the current study was to investigate and describe the clinical practice patterns related to VFSS assessments among Speech-Language Pathologists (SLPs) in India. An electronic survey consisting of 34 questions categorized into four main sections (demographic details and education; current practice; instrumental and technical considerations; protocol and assessment methods) was sent to SLPs registered with the Indian Speech and Hearing Association (ISHA) through email and social media from August 2020 to January 2021. A total of 129 eligible responses were received. More than 50% of the participants used a standard assessment and analysis protocol. Barium and water-soluble contrasts were mostly used, and 97% of participants did not know what percent weight to volume (w/v) or volume to volume (v/v) contrast to fluid were used. Considerable amount of variability was observed in the responses of our participants, which was consistent with international surveys of VFSS practice patterns. Lack of adequate radiation safety measures was also observed. Our findings suggest a need to increase awareness and training among Indian SLPs in technical and procedural aspects of VFSS, and more sensitization toward radiation safety. ISHA should consider forming a committee to develop and adopt uniform nationwide practices in VFSS. Future studies exclusively investigating barriers and facilitators to VFSS practice in the Indian scenario are necessary.

A Survey of Speech-Language Pathologists' Use of Patient Medication Information for Patients With Dysphagia

Purpose: Medications can produce side effects that negatively impact swallowing and cognition. Speech-language pathologists (SLPs) who know which medications their patients are taking are able to consider the potential impact of medication side effects on their patient's swallow function and progress in therapy. The goal of this investigation was to gain preliminary information on how often SLPs report that they review a patient's medications as part of their standard practice, as well as the most common reasons for not reviewing patient medications. Method: A 10-item online questionnaire was distributed to practicing SLPs to collect information regarding their clinical experience, patient caseload, and whether they routinely review patient medications. Logistic regression analysis was used to determine which variables were associated with medication review. Results: Responses were received from 205 SLPs. Approximately half reported “always” reviewing patient medications ( n = 116). The most frequent reason given for not reviewing medications was lack of pharmacology training. The results indicated that SLPs with 15 years or more of experience were nearly 3 times more likely to review medications than SLPs with less experience. Not all Special Interest Groups participated in the distribution of the survey. Conclusions: Many SLPs reported that they did not consistently check patient medications as part of a patient evaluation. Of concern is the possibility that SLPs do not realize the importance of medication knowledge. Clinicians may gain familiarity with the medications and understanding of the impact that medications have on their patients as they accrue clinical experience. Future research should investigate the best ways to promote knowledge of this topic in new clinicians.

A Survey of Speech-Language Pathologists' Experience With Clinical Cough Assessment.

The purpose of this study was to determine if students (clinicians-intraining) and clinicians of speech-language pathology assess cough during clinical swallow evaluations. We also sought to determine if participants received background education and training regarding implementation of clinical cough assessment. Finally, we aimed to identify participant interest in a cough assessment training program. A clinician-researcher panel developed a 20-question survey to address specific aims. The final survey was distributed via social media and a clinical dysphagia website after two phases of revision. A percentage (84.6%) of the survey participants reported that they assess cough in clinical swallow evaluations, mainly using subjective measures. The majority of clinicians reported no background education or skilled training to implement cough assessment. Background education and training was higher for participants outside the United States, although the total sample size of that group was small. Almost all participants (97.8%) were interested in a cough training program. Many practicing clinicians in this survey reported that they complete cough assessments, despite limited education and training to do so. However, they also reported high interest in participating in a clinical cough assessment training program, which would support the field of speech-language pathology and patients at risk of airway protective dysfunction.

What Influences Speech-Language Pathologists' Use of Different Types of Language Assessments for Elementary School–Age Children?

Purpose This study reports on data from a survey of speech-language pathologists' (SLPs) language assessment practices for elementary school-age children. The objective was to investigate the regularity with which SLPs use different types of assessments (described across data types, task types, environmental contexts, and dynamic features). This study also investigated factors that influence assessment practice, the main sources from which SLPs obtain information on language assessment and the main challenges reported by SLPs in relation to language assessment. Method A web-based survey was used to collect information from 407 Australian SLPs regarding the types of assessments they use. Factors that influenced the regularity with which different types of assessments were used were investigated using regression analysis. Results Most SLPs regularly used assessments that are norm-referenced, decontextualized, and conducted in a clinical context and less regularly used other types of assessments. Service agency, Australian state, and SLPs' years of experience were found to influence the regularity with which some types of assessments were used. Informal discussions with colleagues were the most frequently identified source of information on assessment practice. Main challenges related to limited time, lack of assessment materials, and lack of confidence in assessing children from culturally and linguistically diverse backgrounds. Conclusions SLPs could improve current language assessment practice for elementary school-age children through more regular use of some types of assessments. Actions to facilitate evidence-based assessment practice should consider the contextual differences that exist between service agencies and states and address challenges that SLPs experience in relation to language assessment. Supplemental Material https://doi.org/10.23641/asha.14378948.

A Survey of Speech-Language Pathologists' Approaches to Assessing Social Communication Disorders in Children

Purpose The purpose of this article is to explore and describe the approaches and specific assessment tools that speech-language pathologists are currently using to assess social communication disorders (SCDs) in children, in relation to current best practices. Method Ninety-four speech-language pathologists completed an online survey asking them to identify which of the following approaches they use to assess children with SCD: parent/teacher report, naturalistic observation, formal assessment, language sample analysis, interviews, semistructured tasks, and peer/self-report. Participants were also asked to identify specific assessment tools they use within each approach. Results Participants most commonly assess SCDs by combining interviews, naturalistic observation, language sampling, parent/teacher report, and formal assessment. Semistructured tasks and peer/self-report tools were less frequently utilized. Several established parent/teacher report and formal assessment tools were commonly identified for assessing SCDs. Most participants use an informal approach for interviews, language sampling, and naturalistic observations in their SCD assessment process. Conclusions Generally, participants follow best practices for assessing SCDs by combining several different approaches. Some considerations for future assessment are identified, including the use of established protocols in the place of informal approaches in order to make the assessment of SCDs more systematic. Future directions for research are discussed.

Creating Home Practice Programs for Persons with Aphasia: A Survey of Speech Language Pathologists

To investigate the clinical practice among speech-language pathologists (SLP) implementing home programs for people with aphasia.

A Survey of Speech-Language Pathologists' Understanding and Reported Use of Evidence-Based Practice

PurposeThe purpose of this study was to assess speech-language pathologists' (SLPs) understanding and self-reported use of evidence-based practice (EBP). The study also investigated SLPs' opinions toward and barriers to EBP.MethodSLPs (n= 176) from across the United States participated in an online survey designed to assess their understanding and self-reported use of EBP. Participants were recruited via each state's speech-language-hearing association.ResultsA majority of participants were able to identify part of the American Speech-Language-Hearing Association's definition of EBP, but only a small percentage was able to accurately identify the complete, three-part definition. Similarly, most participants could discern between high and low levels of evidence but could not accurately rank all levels. Of a variety of listed sources, participants self-reported the least amount of knowledge for accessing college, university, public, and medical libraries, including online databases through these libraries. American Speech-Language-Hearing Association resources were reported as the most frequently accessed source. Participants self-reported that EBP is beneficial and important but that engaging in EBP can be difficult. The largest barrier to engaging in EBP was lack of time during the workday to stay up-to-date on research. Finally, although participants self-reported a lack of employer-led training in EBP, a majority also self-reported that employers value EBP in the workplace.ConclusionResults suggest SLPs may benefit from increased training on EBP and more time during the workday to engage in EBP. Employers, administrators, and supervisors should consider providing increased training on how to access and utilize peer-reviewed databases. The use of EBP will allow SLPs to improve their clinical practices and provide higher quality treatment to their clients.

Facilitating Parental Involvement in Speech Therapy for Children With Speech Sound Disorders: A Survey of Speech-Language Pathologists' Practices, Perspectives, and Strategies.

Purpose This study investigated the extent to which speech-language pathologists (SLPs) facilitate parents' completion of homework activities for children with speech sound disorder (SSD). In addition, this study explored factors related to more consistent communication about homework completion and strategies considered particularly effective for supporting this element of parental involvement. Method Licensed SLPs serving at least one child with SSD were invited to participate in an online survey. Questions relevant to this study gathered information regarding (a) frequency of communication about homework distribution and follow-up, (b) demographic and workplace characteristics, and (c) an open-ended question about the specific strategies used to support parental involvement and completion of homework activities. Results Descriptive results indicated considerable variability with respect to how frequently SLPs engaged in communication about homework completion, but that school-based SLPs were significantly less likely to engage in this type of follow-up. Strategies considered effective, however, were similar across therapy contexts. Conclusion These results suggest potentially important differences between school-based services and therapy in other contexts with respect to this particular aspect of service provision for children with SSD.

Clinical Implementation of Transcranial Direct Current Stimulation in Aphasia: A Survey of Speech-Language Pathologists.

Purpose The objectives of this study are to (a) identify speech-language pathologists' (SLPs') familiarity with transcranial direct current stimulation (tDCS), (b) quantify what SLPs consider necessary tDCS-related improvement in aphasia severity (i.e., tDCS enhancement; desired improvement above and beyond traditional behavioral therapy) to implement this adjuvant therapy for the clinical management of aphasia, and (c) identify concerns that could potentially hinder the clinical adoption of tDCS. Method A brief (14-question) survey was disseminated via e-mail and social media outlets targeting SLPs working with individuals with aphasia. Results Two hundred twenty-one individuals responded, and 155 valid surveys were analyzed. Seventy-one percent of participants reported familiarity with tDCS prior to taking the survey. Clinicians reported a desired mean enhancement of 22.9% additional points on the Western Aphasia Battery-Revised Aphasia Quotient. Importantly, 94.2% of SLPs reported concerns regarding the implementation of tDCS in clinical settings (i.e., safety, cost, administrative approval, reimbursement and training). Conclusions This is the first study to identify SLPs' perspectives regarding the clinical adoption of tDCS. Results suggest the majority of queried SLPs were familiar with tDCS prior to taking the survey. Although SLPs report a desired improvement of approximately 23% additional points on the Western Aphasia Battery-Revised Aphasia Quotient to consider adopting tDCS into practice, many SLPs reported concerns regarding clinical adoption. Responses from the current survey offer important preliminary evidence to begin bridging the research-to-practice gap as it relates to the clinical implementation of tDCS. Relatedly, these results will inform future clinical trials.

Insights into paediatric tube feeding dependence: A Speech-language pathology perspective

Purpose: To explore possible factors contributing to paediatric tube feeding dependency from the speech-language pathology perspective. Tube feeding dependency can have serious repercussions for children and their families with failed or slow weaning/transitioning from tube to oral feeding, more likely after the age of five. Method: A mixed methods approach was conducted. During the first quantitative phase, an online national survey of speech-language pathologists (SLPs) from the health and non-health sectors was carried out followed by interviews with a subset of the respondents. Forty-three SLPs completed the survey. In the second qualitative phase, 10 participants from the survey were interviewed in depth as to their opinions about why tube dependency occurs. Survey data from phase one were analysed using descriptive statistics and chi square comparisons. Interview data were categorised using thematic analysis. Findings from both methodologies were combined to report the results. Result: Two interlinking meta-themes were identified from the combined data sets. These were: (1) Medicalisation of tube fed children in infancy as a root cause of tube feeding dependency and (2) Fragmentation of the tube fed child’s continuity of care. The specific results indicated several possible reasons for tube feeding dependency including medical emphasis on weight gain, prolonged nasogastric tube feeding and waiting too long for transition from tube to oral feeding. A lack of integrated care and clinician confidence in non-health settings also appeared to be a factor contributing to tube feeding dependency. Conclusion: Early and ongoing biomedical focus on weight gain affected long-term goals for transitioning leading, subsequently, to tube feeding becoming normalised by school age.

Evaluation and Management of Dysphagia in Amyotrophic Lateral Sclerosis: A Survey of Speech-Language Pathologists' Clinical Practice.

Objectives:The aim of this study was to determine the evaluation and management of dysphagia in amyotrophic lateral sclerosis (ALS) patients by speech-language pathologists (SLPs).Methods:A 15-question web-based survey sent to SLPs in general clinical practice.Results:Forty-nine SLPs responded. Although only 8 (17.0%) of the SLPs worked in ALS clinics, 46 (93.9%) had worked with ALS patients. A variety of dysphagia evaluation protocols were used by 43 (97.7%) SLPs. Most SLPs, 40 (88.9%), recommended instrumental assessments, but timing and indication varied greatly: 19 (42.2%) SLPs recommended this at baseline even without bulbar symptoms, whereas others recommended this based on symptoms and/or clinical assessments.Conclusions:There is currently no uniform approach as to the indication, timing, and specific methods to use in the evaluation of dysphagia in ALS patients among SLPs. There is need for further research to assist in the development of definitive guideline recommendations for this population.

Dysphagia Management in Schools: A Survey of Speech-Language Pathologists

Purpose To date, few studies have examined school-based pediatric feeding and swallowing practices across the United States. This study aims to (a) identify barriers to feeding and swallowing service provision in an educational setting and (b) identify the types of service suggested by school-based speech-language pathologists in response to a fictional case study. Method School-based speech-language pathologists and clinical fellows were invited to participate in a 15-min web-based survey. The survey questions addressed demographic and vocational information and perceived barriers to service provision. Survey respondents were also asked to develop a treatment plan in response to a fictional case study. In total, 200 anonymous survey responses were coded and analyzed using qualitative analysis methods. Results A number of barriers to practice were identified, which include academic and/or clinical preparedness and concerns related to the educational relevance of service. Analysis of the case study results indicated a wide range of treatment plans. The most common type of direct intervention suggested was an oral motor exercise regime, followed by diet modifications, and the implementation of safe swallow strategies. Conclusions Information gained in this study may be used to support policies and protocols related to the assessment and treatment of pediatric feeding and swallowing impairment in school settings.

Using Telegraphic Input With Children With Language Delays: A Survey of Speech-Language Pathologists' Practices and Perspectives.

Purpose Speech-language pathologists (SLPs) often simplify their language input when talking to young children with language delays, but there is some controversy regarding whether simplified input should be telegraphic (e.g., Ball under, Doggie go, More toy) or grammatical (e.g., The ball went under; Go, Doggie! More toys). The purpose of this study was to evaluate SLPs' practices and perspectives on using telegraphic input when working with children with language delays at the prelinguistic, one-word, or two-word stages of spoken language development. Method Practicing SLPs were recruited from a university-sponsored professional development conference focused on current best practices in speech-language pathology. Respondents completed an online survey that included questions about their own practices, as well as their overall perspectives on the usefulness of simplifying language input in different ways. Results The vast majority of SLPs (82%) reported using telegraphic input. SLPs reported using telegraphic input more frequently when prompting for verbal imitations than when describing play or providing a directive/request. Surprisingly, only 30% of SLPs who reported using telegraphic input felt that it was useful. SLPs reported that receptive language is the most important child characteristic to consider when deciding what kind of language input to provide. Conclusions These findings suggest the need for more purposeful clinical decision making in the context of providing simplified language input. In addition, in-depth, qualitative studies are needed to characterize the complex interactions among beliefs, experiences, practices, and perspectives pertaining to simplified language input.

Clinical management of childhood apraxia of speech: A survey of speech-language pathologists in Australia and New Zealand

Purpose: A number of studies have been published that have investigated the practices of speech-language pathologists in relation to speech sound disorder intervention; however, specific research about the treatment of childhood apraxia of speech is not available. This study aimed to describe the treatment approaches being used by speech-language pathologists, explore their perspectives of evidence-based practice and identify perceived barriers to implementing empirical research recommendations.Method: An online survey was distributed to speech-language pathologists in Australia and New Zealand. In total, 109 valid surveys were completed by participants who answered a series of multiple choice, yes/no, short answer and Likert-scaled questions.Result: Speech-language pathologists demonstrated a strong preference for eclectic interventions to treat childhood apraxia of speech. When asked to identify the primary treatment approach they used (whether as a stand-alone; or as the primary approach within an eclectic intervention), the most frequently used intervention was the Nuffield Dyspraxia Programme. Many speech-language pathologists reported valuing empirical research evidence, despite identifying a range of barriers that impact their ability to implement evidence-based practice in childhood apraxia of speech treatment.Conclusion: Although many speech-language pathologists use the Nuffield Dyspraxia Programme as their primary intervention, most clinicians use it as part of an eclectic/hybrid intervention. The effectiveness of eclectic interventions for childhood apraxia of speech has not been empirically evaluated.

Current Practice of Child Grammar Intervention: A Survey of Speech-Language Pathologists.

The aim of this study was to better understand current grammatical intervention approaches. Despite grammatical language being a common weakness among children with language impairment, relatively little is known about current grammatical intervention practices of speech-language pathologists (SLPs). Such information is needed to guide the development and evaluation of grammatical interventions and to identify areas in which the current practice is not empirically supported. Participants included 338 SLPs working primarily with children. Participants completed an online survey regarding their implementation of nine different grammatical intervention components, including goals, procedures, dosage, agents, contexts, goal attack strategies, service delivery models, activities, and outcome measurements. Participants also indicated how they would alter the intervention setting and dosage if resources were unlimited. We grouped participants based on the ages of children that represent the largest percentage of their caseload resulting in an early education group (n = 114) and an elementary group (n = 224). We aggregated responses from each question to gain an estimate of current implementation practices associated with each intervention component queried. This study provides general guidelines of current clinical practices to help guide research on grammatical interventions for children and to promote successful translation and implementations of evidence-based treatment approaches. Results may also help clinicians and researchers better understand misalignments between empirically supported intervention approaches and current approaches for treating grammatical weaknesses.

Issues in Assessment of Children Who Stutter: A Survey of Speech-Language Pathologists in the State of North Carolina

Issues in Assessment of Children Who Stutter: A Survey of Speech-Language Pathologists in the State of North Carolina