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Language Sample Analysis in Clinical Practice: Speech-Language Pathologists’ Barriers, Facilitators, and Needs

Purpose: Most speech-language pathologists (SLPs) working with children with developmental language disorder (DLD) do not perform language sample analysis (LSA) on a regular basis, although they do regard LSA as highly informative for goal setting and evaluating grammatical therapy. The primary aim of this study was to identify facilitators, barriers, and needs related to performing LSA by Dutch SLPs working with children with DLD. The secondary aim was to investigate whether a training would change the actual performance of LSA. Method: A focus group with 11 SLPs working in Dutch speech-language pathology practices was conducted. Barriers, facilitators, and needs were identified using thematic analysis and categorized using the theoretical domain framework. To address the barriers, a training was developed using software program CLAN. Changes in barriers and use of LSA were evaluated with a survey sent to participants before, directly after, and 3 months posttraining. Results: The barriers reported in the focus group were SLPs’ lack of knowledge and skills, time investment, negative beliefs about their capabilities, differences in beliefs about their professional role, and no reimbursement from health insurance companies. Posttraining survey results revealed that LSA was not performed more often in daily practice. Using CLAN was not the solution according to participating SLPs. Time investment remained a huge barrier. Conclusions: A training in performing LSA did not resolve the time investment barrier experienced by SLPs. User-friendly software, developed in codesign with SLPs might provide a solution. For the short-term, shorter samples, preferably from narrative tasks, should be considered.

Speech and language therapists’ perceptions of contextual factors associated with communicative participation in children with developmental language disorders

Children with developmental language disorders (DLDs) may experience barriers to communicative participation. Communicative participation is defined as ‘participation in life situations in which knowledge, information, ideas or feelings are exchanged’. Barriers experienced in communicative participation cannot be explained by language competence alone and are thought to be influenced by contextual factors. A better understanding of these factors will contribute to tailored speech and language therapy services for children with DLD. We conducted a focus group study with 13 speech and language therapists’ (SLTs) to explore their perspectives on contextual (environmental and personal) factors in early childhood that are associated with communicative participation in children with DLD. The personal factor of child well-being, and the environmental factors of familial support and SLT service provision were developed through thematic analysis. The potential mediating role of these factors on communicative participation implies that it is important to address contextual barriers and facilitators in speech and language therapy services.

Evaluation of screening for speech/language and non-speech language

Lopend onderzoek in het kader van de onderzoekslijn Kind, Taal & Ontwikkeling. Deze onderzoekslijn maakt deel uit van het Lectoraat Transparante Zorgverleningen en het Lectoraat Integraal Jeugdbeleid. Language problems have impact on school succes (Beichtman et al., 1996, Nelson et al., 2006), behavior (Coster et al., 1999), and quality of life (Van Agt, 2011). Also the comorbidity with other developmental disorders like dyslexia, ADHD and ASS is high (Gerrits, 2011). Psychological wellbeing depends on the interaction with others (Steenbeek & Geert, 2007), in which speech and language are important tools. Identification of children at risk for speech and language delays and related problems may lead to appropriate follow-up and interventions at a young age, when chances for improvement are best (Nelson, 2006). Therefore, it is of great importance to monitor the speech and language development and its consequences during early childhood. In the Netherlands, several protocols exist to detect children with speech and language delay and to guide them to appropriate care. Though, the balance between health benefits, costs, scope and adverse results of these protocols are not evaluated. In 2009, the RIVM and the NCJ formulated a practice based guideline for the screening of children with speech and language delays in Child Health Care (CHC). This position statement is based on consensus in the field. The goal of this study is to collect evidence for the scientific underpinnings of the current practice-based guidelines of the NCJ. We want to evaluate the improvements of speech and language outcomes as well as non speech and language outcomes a year after CHC-screening 2-year-old children.

Collaboration between parents and SLTs produces optimal outcomes for children attending speech and language therapy: Gathering the evidence

Background: Collaboration between parents and speech and language therapists (SLTs) is seen as a key element in family-centred models. Collaboration can have positive impacts on parental and children’s outcomes. However, collaborative practice has not been well described and researched in speech and language therapy for children and may not be easy to achieve. It is important that we gain a deeper understanding of collaborative practice with parents, how it can be achieved and how it can impact on outcomes. This understanding could support practitioners in daily practice with regard to achieving collaborative practice with parents in different contexts. Aims: To set a research agenda on collaborative practice between parents and SLTs in order to generate evidence regarding what works, how, for whom, in what circumstances and to what extent. Methods & Procedures: A realist evaluation approach was used to make explicit what collaborative practice with parents entails. The steps suggested by the RAMESES II project were used to draft a preliminary programme theory about collaborative practice between parents and SLTs. This process generates explicit hypotheses which form a potential research agenda. Discussion & Conclusions: A preliminary programme theory of collaborative practice with parents was drafted using a realist approach. Potential contextual factors (C), mechanisms (M) and outcomes (O) were presented which could be configured into causal mechanisms to help explain what works for whom in what circumstances. CMO configurations were drafted, based on the relevant literature, which serve as exemplars to illustrate how this methodology could be used. In order to debate, test and expand our hypothesized programme theory for collaborative practice with parents, further testing against a broader literature is required alongside research to explore the functionality of the configurations across contexts. This paper highlights the importance of further research on collaborative practice with parents and the potential value of realist evaluation methodology

Which clinical signs are valid indicators for speech language disorder?

Auditory Processing Disorders (APD)

Dit onderzoek is bedoeld om de huidige labelvorming van kinderen met luisterproblemen te onderzoeken en om in samenwerking met logopedisten en audiologen in Nederland te komen tot een uniforme en hanteerbare definitie en om de kennis en ervaring op het gebied van signalering, diagnostiek en behandeling te bundelen. De aanleiding voor dit promotieonderzoek zijn de vragen vanuit het werkveld (logopedisten, audiologen, psychologen AC) over AVP die tijdens presentaties op diverse congressen, in logopedische kwaliteitskringen en dyslexiekringen in de periode 2008-2012 en tijdens de studiedag “Diagnostiek van auditieve verwerkingsproblemen” van de FENAC op 21 mei 2014 (http://www.fenac.nl/algemeen/opleiding/studiedag-avp/studiedag-diagnostiek-van-auditieve-verwerkingsproblemen-avp.html) gesteld werden.