This Week in Speech Science #4
Patient Perception of Speech Outcomes: The Relationship Between Clinical Measures and Self-Perception of Speech Function Following Surgical Treatment for Oral Cancer
Authors: Gabriela Constantinescu, Jana Rieger, Marcy Winget, Catherine Paulsen, and Hadi Seikaly
Background: Patients with oral cancer often have tongue surgery; this causes unintelligible speech. However, are patients perceiving their speech as less intelligible than it actually is?
Participants: 10 patients with oral cancer who had undergone surgery on the anterior ⅔ of the tongue, and some limited other areas.
Preoperative and 1-month postoperative voice recordings.
After this, patients read 50 words (generated by a computer program designed to evaluate dysarthric speech). They also performed a portion of the Fisher-Logemann Test of Articulation. Patient speech was analyzed for phonemic errors.
Patients completed the Speech Handicap Index study, which involves patient-reported data on speech intelligibility.
Patient perception of their articulation (or voice) declined after oral surgery.
The assessment and SLP analysis of patient speech found greater phonemic errors during word and sentence reading. However, for 40% of patients, patient perception of articulation quality was worse than the SLP’s perception.
What this means for your practice:
Even though the patient may have met all of their goals and sounds intelligible to the SLP, they may still perceive their speech as impaired. Therapy should take into account patient perception of their speech, so that they are satisfied with the results of therapy.
Practice Patterns of Speech-Language Pathologists in Pediatric Vocal Health
Authors: Naomi A. Hartley, Maia Braden, and Susan L. Thibeault
Purpose: This study is a survey of how pediatric SLPs provide voice care to students.
Method: Survey sent to 100 SLPs in the United States.
Voice makes up 17.82% of an average SLP’s caseload.
The majority of respondents felt confident providing voice therapy.
The majority of SLPs perform both voice assessment and therapy in their clinic.
The majority of SLPs involve an ENT for instrumental assessment.
What this means for your practice: Even if you are not in a setting that primarily focuses on voice, you will have to be knowledgeable and comfortable with voice therapy.
Observed and Parent-Report Measures of Social Communication in Toddlers With and Without Autism Spectrum Disorder Across Race/Ethnicity
Authors: Sheri T. Stronach and Amy M. Weatherby
Background: Research has shown that there are differences in communication for people of different ethnicities. In addition, it is well known that people with autism communicate differently that those who are neurotypical. Are there ethnic differences in the communication patterns of children with and without autism?
Participants: 364 toddlers (18-36 mos) in 3 ethnic groups: Non-Hispanic White, Black, and Hispanic. Slightly more than half of the participants had been diagnosed with autism.
Communication and Symbolic Behavior Scales Behavior Samples (CSBS-BS) - tests the child’s natural interaction with the clinician and a caregiver.
Early Screening for Autism and Communication Disorders (ESAC) - parent report of child’s behaviors associated with ASD or developmental delays.
ADOS - a popular assessment where trained professionals observe child’s interactions and determine whether the child has autism.
Black and Hispanic children both with and without ASD scored significantly lower on the “Understanding” (receptive language) portion of the CSBS-BS than White children. This may be due to cultural or dialect differences.
Parents of Black children without ASD reported significantly higher features of ASD on the ESAC. This may be because of differences in interpreting the questions on this assessment.
Mothers who had fewer years of education reported more features of autism in their children.
What This Means for Your Practice:
The CSBS-BS and ESAC can be used to help diagnose autism at an early age for diverse populations. However, like any assessments, these two have limitations and should be interpreted as part of a dynamic assessment sequence that takes into account the child’s linguistic and cultural factors.
Note: One of the authors of the study has a financial interest in the CSBS.
Longitudinal Impacts of Print-Focused Read-Alouds for Children With Language Impairment
Authors: Laura M. Justice, Jessica Logan, and Joan N. Kaderavek
Background: Children with language impairment (LI) have delays in acquiring literacy skills, including preliteracy skills that develop before learning how to read. One type of preliteracy skill is print awareness, where children are aware of the existence of words and the function of print. One way to improve print awareness is to read a story while focusing on the print aspects of the book. Previous studies have shown that print-focused read-alouds improve print awareness in the short term.
Research Question: Do print-focused read-alouds have long-term (1 year post-intervention) sustained benefits? Also, are these interventions more effective for children with low nonverbal cognition?
Participants: 172 children (initial ages 45-64 months) with language impairment.
Children were identified as LI, as they were part of a previous study that required them to have LI.
They were randomly assigned to three conditions:
Parents and teachers read as they normally would.
Parents read normally, teachers used print-focused read-alouds.
Both parents and teachers use print-focused read-alouds.
Parents and teachers were assigned the same book and were asked to read them 4 times a week (2 times a week for caregivers).
Assessments were given at baseline, immediately post-intervention, and one year post-intervention:
Preschool Word and Print Awareness - 14 questions embedded into story to examine if the child knows book and print concepts (e.g. where the front of the book is, how to turn pages).
Name Writing - children provided with a sheet of paper, and were asked to draw a self-portrait and sign their name.
Results: One year post-intervention, the improvements in the two assessments did not fade.
What this means for your practice: Print-focused read-alouds are a low-cost yet effective way to increase print awareness long-term for children with language impairments.
A Comparison of the Metalinguistic Performance and Spelling Development of Children With Inconsistent Speech Sound Disorder and Their Age-Matched and Reading-Matched Peers
Authors: Brigid C. McNeill, Julie Wolter, and Gail T. Gillon
Background: Children with speech sound disorders (SSDs) can have issues with literacy. For example, they may have delays in phonemic awareness and spelling development. In addition, they are likely to have delays in spelling development. However, the specific literacy deficits of children with SSDs are not known.
Research Question: Compared to typically developing age-matched and reading ability-matched children, how do children with SSDs perform on metalinguistic and word-level literacy tasks? In addition, do children with resolved SSD perform better on these tasks than those with persistent SSD?
Participants: 28 children aged 6.5-8.5 years with SSD who were part of a longitudinal study in New Zealand. There were two control groups of 28 children each. One group had the same chronological age as the experimental group, and the other group had similar reading scores on the Woodcock-Johnson as the experimental children. All three groups were from similar socioeconomic backgrounds.
Test of Phonological Awareness-Early Elementary: tests receptive phoneme awareness by having children identify which word ends with a different sound out of a field of four.
Orthographic Awareness: The examiner spoke nonwords, and children were asked to identify the most plausible spelling out of a written field of three.
Morphological Awareness: children were to show understanding of morphology (e.g. transform “quick” into “quickly”).
A spelling test, where every word had at least one bound morpheme (i.e. a part of the word that couldn’t stand on its own, e.g. unkind).
Children with isolated SSD perform worse on metalinguistic (i.e. awareness) and spelling tasks than age-matched peers.
Children with SSD also performed worse on these tasks than younger reading level-matched children.
Children with resolved SSD performed better than those with persistent SSD, but continued to present with deficits.
What this means for your practice: Children with SSD need maximal instruction in encoding and decoding skills to increase their literacy skills, as their literacy levels are lower than typical peers.