Medicine and Health Sciences Commons^™

Working Towards Recommended Terminology In The Canadian Preschool Speech-Language Pathology Context, Alison Csercsics, Lisa Md Archibald, Barbara Jane Cunningham

PRECISe Preschool Speech and Language Publications

Purpose: This quality improvement project aimed to address the inconsistent use of clinical labels across a preschool speech and language program in Ontario, Canada. The study investigated whether a multi-component knowledge translation intervention could increase speech-language pathologists’ (SLPs’) knowledge about the recommended clinical labels, motivate their intentions to use the labels, and facilitate practice change during a three-month pilot period.

Method: The Diffusion of Innovations Theory was utilized to identify and address known and suspected barriers and facilitators that could influence the adoption of consistent terminology. The intervention was evaluated using a pre-experimental study design (with pre-post-follow-up testing) and included …

Validation Of An Integrated Pressure Level Measured Earmold Wideband Real-Ear-To-Coupler Difference Measurement, Matthew Urichuk, David Purcell, Prudence Allen, Susan Scollie

Communication Sciences and Disorders Publications

Objective: To validate measurement of predicted earmold wideband real-ear-to-coupler difference (wRECD) using an integrated pressure level (IPL) calibrated transducer and the incorporation of an acoustically measured tubing length correction. Design: Unilateral earmold SPL wRECD using varied hearing aid tubing length and the proposed predicted earmold IPL wRECD measurement procedure were completed on all participants and compared. Study Sample: 22 normal hearing adults with normal middle ear status were recruited. Results: There were no clinically significant differences between probe-microphone and predicted earmold IPL wRECD measurements between 500 and 2500 Hz. Above 5000 Hz, the predicted earmold IPL wRECD exceeded earmold SPL …

Development And Initial Evaluation Of The Hearing Aid Attribute And Feature Importance Evaluation (Hafie) Questionnaire, Hasan Saleh, Paula Folkeard, Selina Liao, Susan Scollie

Communication Sciences and Disorders Publications

Objectives: To develop and validate a novel questionnaire aimed at providing a structured, evidence-based methodology for hearing aid recommendation and selection using self-reported importance ratings for different modern hearing aid features. Design: The initial questionnaire items were created through a concept mapping approach that involved input from hearing aid users. Hearing care professional focus groups (n¼10) were conducted to assess questionnaire content and design, and to guide modifications. Validation of this initial 34-item version of the questionnaire was conducted using an anonymous online survey tool (Qualtrics). Exploratory factor analysis was used to assess the factor structure of the dataset, using …

An Evaluation Of The Carl Manikin For Use In "Patient-Free" Real Ear Measurement: Consistency And Comparison To Normative Data., Paula Folkeard, Muneeb Alam, Robert Koch, Parvaneh Abbasalipour, Susan Scollie

Communication Sciences and Disorders Publications

OBJECTIVE: Simulation-based learning experiences provide low-risk opportunities for procedural training and practice in audiology. A series of real ear measurements (REM) were completed using Clinical Assistant for Research and Learning (CARL) manikins to determine expected responses and to compare to normative data.

DESIGN: (1) Real-ear Unaided Response (REUR) curves were measured with one CARL and each of three ear styles. (2) Test/retest reliability was evaluated by repeating each REUR. (3) Real ear to coupler difference (RECD) values for foam-tip and custom earmolds were calculated. (4) The reliability across copies of the CARL heads was evaluated by comparing REUR measurement from …

Families' Experiences In The Virtual Hanen More Than Words Program During The Covid-19 Pandemic, Lauren Denusik, Michelle Servais, Danielle Glista, Kathryn Hatherly, Sheila Moodie, Janis Oram Cardy, Elaine Weitzman, Bj Cunningham

PRECISe Preschool Speech and Language Publications

Abstract

Purpose: The COVID-19 pandemic required most pediatric rehabilitation programs to shift to a virtual delivery format without the benefits of evidence to support this transition. Our study explored families' experiences participating virtually in More Than Words, a program for parents of autistic children, with the goal of generating new evidence to inform both virtual service delivery and program development.

Method: Twenty-one families who recently completed a virtual More Than Words program participated in a semistructured interview. The interviews were transcribed and analyzed in NVivo using a top-down deductive approach that referenced a modified Dynamic Knowledge Transfer Capacity model. …

Interrater Reliability Of The Focus-34: Parent-To-Parent And Parent-To-Clinician, Barbara Jane Cunningham, Peter Rosenbaum, Anastasia Nepotiuk, Nancy Thomas-Stonell

PRECISe Preschool Speech and Language Publications

This brief report presents interrater reliability data for the Focus on the Outcomes of Communication Under Six (FOCUS-34) between parents, and between parents and speech-language pathologists (SLPs). Reliability for all three raters combined was good to excellent across three assessments. Reliability for pairs of raters was variable but generally good.

Modified Multiple Stimulus With Hidden Reference And Anchors–Gabrielsson Total Impression Sound Quality Rating Comparisons For Speech In Quiet, Noise, And Reverberation, Mohamed Rahme, Paula Folkeard, Steve Beaulac, Susan Scollie, Vijay Parsa

Communication Sciences and Disorders Publications

Purpose:

The purpose of the study was to obtain, analyze, and compare subjective sound quality data for the same test stimuli using modified multistimulus MUSHRA (Multiple Stimulus with Hidden Reference and Anchors) based procedures (viz., MUSHRA with custom anchors and MUSHRA without anchor) and the single-stimulus Gabrielsson's total impression rating procedure.

Method:

Twenty normally hearing young adults were recruited in this study. Participants completed sound quality ratings on two different hearing aid recording data sets—Data Set A contained speech recordings from four different hearing aids under a variety of noisy and processing conditions, and Data Set B contained speech recordings …

Engaging Clinical End Users In The Development Of An Outcome Measurement Protocol For Pediatric Communicative Health Systems, Victoria Sherman, Danielle Glista, Barbara Jane Cunningham

PRECISe Preschool Speech and Language Publications

Purpose: To develop a conceptual framework of the factors likely to influence clinicians' use of a new participation-focused outcome measurement protocol in a large paediatric speech-language pathology program.Method: A convenience sample of 27 end users (clinicians, managers) were recruited from Ontario, Canada's Preschool Speech and Language Program. Participants engaged in one virtual concept mapping session in groups of five to six during which they learned about the new protocol, and generated statements in response to a prompt asking them to identify factors that would influence their use of the protocol. Following all sessions, participants asynchronously sorted and …

Speech-Language Pathologists’ Treatment Goals For Preschool Language Disorders: An Icf Analysis, Elaine Yl Kwok, Peter Rosenbaum, Barbara Jane Cunningham

PRECISe Preschool Speech and Language Publications

Purpose: The World Health Organization's International Classification of Functioning, Disability and Health (ICF) provides a comprehensive framework to conceptualise clinical services. This study explored how speech-language pathologists (SLPs) conceptualised therapy goals for preschoolers with language difficulties and disorders within the ICF framework.Method: An online survey was distributed to SLPs practising in a publicly funded Preschool Speech and Language program in Ontario, Canada. SLPs rated their familiarity with the ICF framework, and then reported all therapy goals for one child with language difficulty/disorder on their caseload. For each reported goal, SLPs indicated the ICF component(s) they felt the …

Virtual Hearing Aid Care: Clinical Practice Guideline V2.0, Danielle Glista, Robin O'Hagan, Danielle Leah Difabio, Sheila Theresa Frances Moodie, Karen Munoz, Frances Richert, Ioan Curca, Christine Meston, David Pfingstgraef, Keiran Joseph, Christine L. Brown

Communication Sciences and Disorders Publications

This clinical practice guideline (CPG) provides guidance around the delivery of virtual hearing aid care according to hearing healthcare professional practices and responsibilities, informed implementation strategies, clinical decision frameworks, and technology and infrastructure requirements. Guidance aligns with person-centred care approaches across four virtual care types: hearing aid management, programming, verification, and validation. CPG recommendations are based on evidence resulting from systematic literature review and co-creation efforts from an international team of hearing healthcare providers and clinician/scientist leaders in the field.

A Scoping Review Of Technology And Infrastructure Needs In The Delivery Of Virtual Hearing Aid Services, Danielle Difabio, Robin O'Hagan, Danielle Glista

Communication Sciences and Disorders Publications

Purpose: The digital health revolution has brought forward integral technological advancements enabling virtual care as a readily accessible delivery model. Despite this forward momentum, the field of audiology still faces barriers that impede the uptake of virtual services into routine clinical practice. The aim of this study was to gather, synthesize, and summarize the literature around virtual hearing aid intervention studies and the related technology and infrastructure requirements.

Method: A scoping review was conducted using MEDLINE, CINAHL, Scopus, Nursing and Allied Health, and Web of Science databases. Objectives, inclusion criteria, and scoping review methods were specified in advance and documented …

Intervention Goals For Preschoolers With Language Difficulties And Disorders A Scoping Review Using The Icf Framework, Elaine Kwok, Carly A. Cermak, Kathryn Hatherly, Barbara Jane Cunningham

PRECISe Preschool Speech and Language Publications

Purpose: The primary aim of this scoping review was to categorize language therapy goals reported in intervention studies for preschoolers (i.e., children from 0 to 5;0 years old) with language difficulties and disorders within the World Health Organization’s International Classification of Functioning, Disability and Health (ICF) framework. A secondary aim was to determine whether different therapy goals were reported for different language difficulty/disorder subtypes (i.e., comparing language difficulty/disorder associated with a biomedical condition to those without an associated biomedical condition).

Method: The scoping review followed Arksey and O’Malley’s (2005) guidelines. Articles were retrieved from speechBITE, with age (under …

Usability And Feasibility Of A Spoken Language Outcome Monitoring Procedure In A Canadian Early Hearing Detection & Intervention Program: Results Of A 1-Year Pilot, Olivia Daub University Of Western Ontario, Bj Cunningham, Marlene P. Bagatto, Janis Oram Cardy

PRECISe Preschool Speech and Language Publications

Purpose: Best practice recommendations for Early Hearing Detection and Intervention (EHDI) programs include routine spoken language outcome monitoring. The present article reports on pilot data that evaluated the usability and feasibility of a spoken language outcome monitoring procedure developed for Ontario’s Infant Hearing Program (IHP). This procedure included both Program-level monitoring using omnibus language tests from birth to 6 years of age and individual vulnerability monitoring of key domains of spoken language known to be at risk in children who are deaf or hard of hearing.

Methodology: Speech-language pathologists (SLPs) in the IHP piloted the new procedures for one year …

The Process Of Telepractice Implementation During The Covid-19 Pandemic: A Narrative Inquiry Of Preschool Speech-Language Pathologists And Assistants From One Center In Canada, Elaine Yl Kwok, Jessica Chiu, Peter Rosenbaum, Barbara Jane Cunningham

PRECISe Preschool Speech and Language Publications

Background: Many professional services were pressed to adopt telepractice in response to the global coronavirus SARS-CoV-2 (COVID-19) pandemic. The need to adopt a new service delivery approach quickly created different implementation challenges. This study explored the lived experiences of frontline clinicians who successfully transitioned their in-person speech-language therapy services to telepractice through an implementation science lens.

Methods: The study was conducted in partnership with one publicly funded program in Ontario, Canada that offers services to preschoolers with speech, language and communication disorders. Sixteen frontline speech-language pathologists and assistants at this organization shared their lived experience transitioning to telepractice during the …

What Do Speech-Language Pathologists Want To Know When Assessing Vocal Development In Children Who Are Deaf/Hard-Of-Hearing?, Olivia Daub, Marlene P. Bagatto, Janis Oram Cardy

PRECISe Preschool Speech and Language Publications

Abstract

Purpose: Delays in vocal development are an early predictor of ongoing language difficulty for children who are deaf/hard-of-hearing (CDHH). Despite the importance of monitoring early vocal development in clinical practice, there are few suitable tools. This study aimed to identify the clinical decisions that speech-language pathologists (SLPs) most want to make when assessing vocal development and their current barriers to doing so.

Method: 58 SLPs who provide services to CDHH younger than 22 months completed a survey. The first section measured potential barriers to vocal development assessment. The second section asked SLPs to rate the importance of 15 clinical …

Current Practices, Supports, And Challenges In Speech-Language Pathology Service Provision For Autistic Preschoolers, Amanda V. Binns, Barbara Jane Cunningham, Allison Andres, Janis Oram Cardy

PRECISe Preschool Speech and Language Publications

Background: Speech-language pathology services are among the most frequently accessed services for young autistic children. Therefore, understanding the nature of these services, what challenges these clinicians face, and what supports they value is critical for developing appropriate policies and practices that can maximize positive outcomes for children and families. This study had two primary aims. The first was to examine the self-reported assessment and intervention practices of community-based Speech Language Pathologists (SLPs) and communicative disorders assistants (CDAs; who provide services under the supervision of a SLP) in supporting preschool children with suspected and diagnosed autism. The second aim was to …

Exploring Practice-Based Clinical–Research Partnerships In Speech-Language Pathology: A Scoping Review, Meghan Vollebregt, Lisa Archibald, Julie Theurer, Janis Oram Cardy

PRECISe Preschool Speech and Language Publications

Collaborative partnerships between speech-language pathologists and researchers present an opportunity for practice-based research. For practice-based research to become more widely used in speech-language pathology, a crucial step is outlining the potential purposes and outcomes of these partnership projects. The current article is two-fold. First, we describe a model for practice-based partnerships between researchers and speech-language pathologists. The practice-based research cocreation model developed for this project includes three distinct partnership outcomes: (a) creating practice, (b) capturing current practice, and (c) changing practice. Then, informed by our model, we completed a scoping review to explore the extent and type of practice-based research …

Looking Back And Moving Forward: A Scoping Review Of Research On Preschool Autism Interventions In The Field Of Speech-Language Pathology, Amanda Binns, Rachael Smyth, Allison Andres, Joyce Lam, Janis Oram Cardy

PRECISe Preschool Speech and Language Publications

Background & Aims: Speech-language pathology services are frequently accessed by families of children who have suspected or diagnosed autism. This is expected given that social communication differences are a core feature of autism. This review looked broadly at the state of research in the field of speech-language pathology and preschool autism interventions in order to identify the types of studies that could be used to inform the practices of speech-language pathologists (SLPs), and to identify gaps in the field so they can be addressed in future research. Specifically, we examined the extent of research conducted on interventions delivered (at least …

Speech-Evoked Brain Activity Is More Robust To Competing Speech When It Is Spoken By Someone Familiar, Emma Holmes, Ingrid S. Johnsrude

Communication Sciences and Disorders Publications

When speech is masked by competing sound, people are better at understanding what is said if the talker is familiar compared to unfamiliar. The benefit is robust, but how does processing of familiar voices facilitate intelligibility? We combined high-resolution fMRI with representational similarity analysis to quantify the difference in distributed activity between clear and masked speech. We demonstrate that brain representations of spoken sentences are less affected by a competing sentence when they are spoken by a friend or partner than by someone unfamiliar—effectively, showing a cortical signal-to-noise ratio (SNR) enhancement for familiar voices. This effect correlated with the familiar-voice …

Adopting A Conceptual Validity Framework For Testing In Speech-Language Pathology, Olivia Daub, Barbara Jane Cunningham, Marlene P. Bagatto, Andrew M. Johnson, Elaine Y. Kwok, Rachael E. Smyth, Janis Oram Cardy

Communication Sciences and Disorders Publications

Purpose Limited evidence-based guidelines for test selection continue to result in inconsistency in test use and interpretation in speech-language pathology. A major barrier is the lack of explicit and consistent adoption of a validity framework by our field. In this viewpoint, we argue that adopting the conceptual validity framework in the Standards for Educational and Psychological Testing (American Educational Research Association et al., 2014) would support both the development of more meaningful and feasible clinical tests and more appropriate use and interpretation of tests in speech-language pathology. Method We describe and evaluate the (American Educational Research Association et al., 2014) …

Reliability Of Speech-Language Pathologists’ Categorizations Of Preschoolers’ Communication Impairments In Practice, Bj Cunningham, Janis Oram Cardy

PRECISe Preschool Speech and Language Publications

Abstract

Method

Results

Strengths And Challenges Of The Cosmin Tools In The Appraisal Of Outcome Measures: A Case Example For Speech-Language Therapy, Elaine Kwok, Peter Rosenbaum, Nancy Thomas-Stonell, Barbara Jane Cunningham

PRECISe Preschool Speech and Language Publications

Background: The Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) is an international initiative that offers standardized and validated tools to guide the appraisal of outcome measures in healthcare.

Aims: This study aimed to explore the use of a new set of tools from COSMIN to appraise studies on outcome measures available to speech and language therapists (SLTs).

Methods: We used the COSMIN tools to appraise seven studies and a user manual that reported the measurement properties of the Focus on the Outcomes of Children Under Six (FOCUS), a validated measure of preschoolers’ communicative participation that …

Exploring Speech And Language Intervention For Preschoolers Who Are Deaf And Hard Of Hearing: A Scoping Review, Janis Oram Cardy, Hillary Ganek

PRECISe Preschool Speech and Language Publications

Purpose: The objective of this study was to summarize the extant literature on the effectiveness of speech and spoken language interventions for young children who are deaf or hard of hearing (DHH) to determine which types of speechlanguage interventions might be most effective, for which hearing levels and types of hearing losses, and at which dosage.

Methods: Using a scoping review methodology, a database search identified 10,360 studies of which 16 met the requirements for inclusion. Data was extracted from each for analysis.

Results: Due to the limited number of studies available, high variability in the nature of the studies, …

Barriers And Facilitators To Implementation Of A Preschool Outcome Measure: An Interview Study With Speech-Language Pathologists, Elaine Yl Kwok, Sheila Tf Moodie, Bj Cunningham, Janis Oram Cardy

PRECISe Preschool Speech and Language Publications

Barriers and Facilitators to Implementation of a Preschool Outcome Measure: An Interview Study with Speech-Language Pathologists

Abstract

Introduction: The Preschool Speech and Language Program in Ontario, Canada implemented the Focus on the Outcomes of Communication Under Six (FOCUS), an outcome measure, in 2012. This study aimed to investigate commonly experienced facilitators of and barriers to implementing the FOCUS in clinical practice from the perspectives of speech-language pathologists (SLPs). Methods: Thirty-seven SLPs participated in semi-structured interviews to share their experiences adopting the FOCUS in clinical practice. A deductive content analysis of interview transcripts was conducted using the Theoretical Domains …

Investigating The Role Of Inattention And/Or Hyperactivity/Impulsivity In Language And Social Functioning Using A Dimensional Approach, Kaitlyn M.A. Parks, Janis E.Oram Cardy, Tiffany G. Woynaroski, Claudia G. Sehl, Ryan A. Stevenson

Communication Sciences and Disorders Publications

© 2020 Elsevier Inc. The current study parsed out the distinct components of attention-deficit/hyperactivity disorder (ADHD) symptomatology to examine differential relations with language and social ability. Using a research domain criteria (RDoC) framework, we administered standardized tests and previously developed and validated questionnaires to assess levels of inattention and/or hyperactivity/impulsivity symptomatology, language, social responsivity and social competency in 98 young adults. Those with higher inattention and/or hyperactivity/impulsivity symptomatology had reduced language comprehension, social responsivity, and social competency. Inattention and hyperactivity/impulsivity both predicted language comprehension, but not language production. Interestingly, inattention uniquely contributed to social responsiveness and social competency, but hyperactivity/impulsivity …

Perceived Sound Quality Dimensions Influencing Frequency-Gain Shaping Preferences For Hearing Aid-Amplified Speech And Music, Jonathan M. Vaisberg, Steve Beaulac, Danielle Glista, Ewan A. Macpherson, Susan D. Scollie

Communication Sciences and Disorders Publications

© The Author(s) 2021. Hearing aids are typically fitted using speech-based prescriptive formulae to make speech more intelligible. Individual preferences may vary from these prescriptions and may also vary with signal type. It is important to consider what motivates listener preferences and how those preferences can inform hearing aid processing so that assistive listening devices can best be tailored for hearing aid users. Therefore, this study explored preferred frequency-gain shaping relative to prescribed gain for speech and music samples. Preferred gain was determined for 22 listeners with mild sloping to moderately severe hearing loss relative to individually prescribed amplification while …

Developing A Spoken Language Outcome Monitoring Procedure For A Canadian Early Hearing Detection And Intervention Program: Process And Recommendations, Janis Oram Cardy, Olivia Daub University Of Western Ontario

PRECISe Preschool Speech and Language Publications

Abstract

Purpose: Routine spoken language outcome monitoring is one component of Early Hearing Detection and Intervention (EHDI) programs for children who are hard of hearing and learning a spoken language. However, there is no peerreviewed research that documents how spoken language outcome monitoring may be achieved, or what processes EHDI programs can use to develop these procedures. The present article describes the process used by a Canadian EHDI program and the final recommendations that were developed from this process.

Methodology: Through consultation with the program’s stakeholders, consideration of the Joint Committee on Infant Hearing’s recommendations, and drawing on our own …

Implementing Evidence-Based Assessment Practices For The Monitoring Of Spoken Language Outcomes In Children Who Are Deaf Or Hard Of Hearing In A Large Community Program, Barbara Jane Cunningham, Janis Oram Cardy, Olivia Daub University Of Western Ontario

PRECISe Preschool Speech and Language Publications

The purpose of this quality improvement pilot was to evaluate the effectiveness of an online learning module for (a) changing speech-language pathologists’ perceptions about outcome monitoring and assessment protocols for children who are deaf or hard of hearing and (b) supporting speech-language pathologists’ understanding of evidence-based protocols to be implemented in their community-based program. Using principles of integrated knowledge translation and the Ottawa Model of Research Use, an online learning module was designed to support the implementation of evidence-based assessment protocols for these children in a large publicly funded program in Ontario, Canada. A pre–post study was then conducted with …

Assessing Communicative Participation In Preschool Children With The Focus On The Outcomes Of Communication Under Six: A Scoping Review, Barbara Jane Cunningham, Nancy Thomas-Stonell, Peter Rosenbaum

PRECISe Preschool Speech and Language Publications

Aim: To describe uses of the Focus on the Outcomes of Communication Under Six (FOCUS) in research since its publication in 2010. Method: Six databases were searched for the term ‘Focus on the Outcomes of Communication Under Six’. With additional searches we ascertained 70 articles, of which 25 met inclusion criteria for full review and data extraction. Results: The FOCUS has been used in research across multiple countries, purposes, populations, contexts, and versions. Evaluative studies have described the development of children’s communicative participation skills and factors that impact development of communicative participation; the impact of specific interventions …

Perceptual Benefits Of Extended Bandwidth Hearing Aids With Children: A Within-Subject Design Using Clinically Available Hearing Aids, Maaike Van Eeckhoutte, Susan Scollie, Robin O’Hagan, Danielle Glista

Communication Sciences and Disorders Publications

© American Speech-Language-Hearing Association. All rights reserved. Purpose: The aim of the study was to investigate the achieved audibility with clinically available, modern, high-end, behind-the-ear hearing aids fitted using the Desired Sensation Level v5.0 child prescription for a clinical sample of children with hearing impairment and the effect of the extended bandwidth provided by the hearing aids on several outcome measures. Method: The achieved audibility was measured using the maximum audible output frequency method. Twenty-eight children (7–17 years old) with mild to severe hearing losses completed this study. Two hearing aid conditions were fitted for each participant: an extended bandwidth …