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This paper provides an introduction to epistemic trust for speech-language pathologists (SLPs). ‘Epistemic trust’ describes a specific form of trust that an individual places in others when learning about the world, particularly the social world. To date, the relevance of epistemic trust to SLP clinical practice has received little theoretical or empirical attention. The aim of this paper is to define epistemic trust and explain its relationship with parent-child attachment and mentalization which have, in turn, been linked with language development and use. Suggestions are made for ways in which SLPs may encourage epistemic trust in clients, emphasizing the need to establish strong therapeutic alliances. The authors conclude that epistemic trust is an important consideration for SLPs and that further research exploring the relationship between epistemic trust and language skills is needed to better understand the interplay of these variables and inform clinical practice. [ABSTRACT FROM AUTHOR]

• People with autoimmune neurological diseases can have language difficulties. • Language difficulties can be in production and comprehension. • Language difficulties can relate to specific language tasks. • Language difficulties may co-occur with specific brain damage. • Only a few studies administered standardized tests. Autoimmune neurological diseases (ANDs) are a specific type of autoimmune disease that affect cells within the central and peripheral nervous system. ANDs trigger various physical/neuropsychiatric symptoms. However, language impairments in people with ANDs are not well characterized. Here we aimed to determine the kinds of language impairment that most commonly emerge in 10 ANDs, the characteristics of the patients (demographic, neurological damage), and the assessment methods used. We followed the PRISMA Extension for Scoping Reviews (PRISMA-ScR). PubMed and Google Scholar were searched. We used a list of search terms containing 10 types of ANDs (e.g., multiple sclerosis, acute disseminated encephalomyelitis) in combination with the terms aphasia, dysphasia, fluency, language, listening, morphology, phonology, pragmatics, reading, semantics, speaking, syntax, writing. The reference lists and citations of the relevant papers were also investigated. The type of AND, patient characteristics, neurological damage and examination technique, language tests administered, and main findings were noted for each study meeting the inclusion criteria. We found 171 studies meeting our inclusion criteria. These comprised group studies and case studies. Language impairments differed largely among types of ANDs. Neurological findings were mentioned in most of the papers, but specific language tests were rarely used. Language symptoms in people with ANDs are commonly reported. These are often not full descriptions or only focus on specific time points in the course of the disease. Future research needs to assess specific language functions in people with ANDs and relate their language impairments to brain damage at different stages of disease evolution. [ABSTRACT FROM AUTHOR]

Central auditory processing disorders (CAPD) can significantly affect the daily functioning of a child, and the first step in determining whether rehabilitation procedures are required is a proper diagnosis. Different guidelines for making diagnoses have been published in the literature, and in various centers normative values for psychoacoustic tests of CAPD have been used internally. The material presented in this paper is based on more than 1000 children and is the largest collection so far published. The aim of this study is to present normative values for tests assessing CAPD in children aged 6 to 12 years, divided by age at last birthday. We tested 1037 children aged 6 to 12 years who were attending primary schools and kindergartens. The criteria for inclusion were a normal audiogram, intellectually normal, no developmental problems, and no difficulties in auditory processing. To evaluate auditory processing all children were given three tests on the Senses Examination Platform: the Frequency Pattern Test (FPT), Duration Pattern Test (DPT), and Dichotic Digit Test (DDT). The results from 1,037 children allowed us to determine normative values for FPT, DPT, and DDT in seven different age groups (6 through to 12 years). We developed a newapproach, based on quantile-based norms, to determine normative values in each group. Three categories – average, below-average, and above-average – allow for a broader but more realistic interpretation than those used previously. We compare our results with published standards. Our study is the largest normative database published to date for CAPD testing, setting a standard for each child by age in years. We used the Senses Examination Platform, a universal tool, to unify standards for the classification of CAPD. Our study can serve as a basis for the development of a Polish model for the diagnosis of CAPD. [ABSTRACT FROM AUTHOR]

• Errorless, errorful and retrieval practice prioritize success and effort differently. • Different mechanisms of action may underly errorless, errorful and retrieval practice. • Mechanisms of action may guide how treatments can be modified to meet client needs. • Effort, accuracy, cognition, and affect may influence learning during treatment. • Clinicians can modify interventions to optimize learning considering treatment theory. There is a growing body of literature demonstrating that language rehabilitation can improve naming impairments for individuals with aphasia. However, there are challenges applying evidence-based research to clinical practice. Well-controlled clinical studies often consist of homogenous samples and exclude individuals who may confound group-level results. Consequently, the findings may not generalize to the diverse clients serviced by speech-language therapists. Within evidence-based guidelines, clinicians can leverage their experiences and theoretical rationale to adapt interventions to meet the needs of individual clients. However, modifications to evidence-based interventions should not alter aspects of treatment that are necessary to produce change within the treatment target. The current discussion paper uses errorless learning, errorful learning, and retrieval practice for naming in aphasia to model how treatment theories can guide clinicians in making theory-informed modifications to interventions. First, we briefly describe the learning mechanisms hypothesized to underlie errorless learning, errorful learning, and retrieval practice. Next, we identify ways clinicians can provide targeted supports to optimize learning for individual clients. The paper ends with a reflection on how well-defined treatment theories can facilitate the generation of practice-based evidence and clinically relevant decision making. [ABSTRACT FROM AUTHOR]

Primary progressive aphasia (PPA) is a neurodegenerative dementia in which language impairment is the first and most dominant symptom. There is a considerable dearth of interventions for PPA although language rehabilitation has made headway in managing the disorder. Thus far, no comprehensive services have been proposed for PPA clients and/or their spouses. This paper describes the first structured group intervention program designated exclusively for people with PPA and their caregivers. This pilot project originates from a clinical service and presents supporting evidence for initiation of a larger study to establish an evidence-based intervention for PPA. A 10-week intervention program comprised working on language activities, learning communication strategies, counselling and education. Outcome measures administered to participants and their spouses before and after the intervention were compared showed improvements in quality of communication and coping skills in the PPA group compared to controls. Qualitative comments from all 10 participants in the active treatment group highlighted the necessity of intervention that is tailored specifically to the PPA population and addresses the needs of both individuals with PPA and their caregivers. All participants in the intervention group contributed to the study and are also co-authors of this paper. [ABSTRACT FROM AUTHOR]

• A later start of English as a foreign language (EFL) lessons is beneficial to pupils with DLD. • Pupils with more positive attitudes towards EFL lessons obtain higher scores. • In pupils with DLD, more EFL anxiety is associated with lower achievement. • Predictors of EFL achievement change over time. Like children with typical language development, their peers with developmental language disorder (DLD) are expected to learn English as a foreign language (EFL). For pupils without DLD, it is well-established that amount of informal exposure to English outside of the classroom, starting age of EFL instruction and motivation are strong positive predictors of EFL learning rate and/or achievement, whereas anxiety is negatively related to performance. This paper is the first attempt to investigate how these predictors of EFL performance operate in learners with DLD. Participants were nineteen Dutch-speaking 7th graders with DLD learning English as a school subject at a specialist education facility in the Netherlands. English receptive grammar and receptive vocabulary were measured twice, with a four-month interval. Foreign language learning motivation, anxiety and (length and amount of) informal exposure to and instruction in English were measured via questionnaires. The participants did not show any progress on English vocabulary and grammar. At Time 1, vocabulary and grammar scores were positively related to starting age of EFL instruction and negatively related to anxiety. For vocabulary, achievement was also positively predicted by attitudes towards English lessons. Only the relationship between starting age of instruction and vocabulary outcomes was visible at Time 2. Amount and length of informal exposure to English did not predict performance, which is in stark contrast to the patterns observed in EFL learners with typical language development. We conclude that children with DLD benefit from a later onset of foreign language lessons, whereas length and amount of out-of-school exposure to English are less important in the context of DLD, possibly due to difficulty with implicit learning. [ABSTRACT FROM AUTHOR]

• Patients with aphasia/families frequently report negative acute care experience. • Documented effectiveness of CPT; limited evidence re: sustainability in hospital context. • Acute care stroke context complex with many competing demands. • Sustainability requires implementation practice beyond implementation science/research. • Need for focus on individual/organizational readiness, motivation and leadership buy-in. Patient experience for people with aphasia/families in acute care is frequently reported as negative, with communication barriers contributing to adverse events and significant long-term physical and psychosocial sequelae. Although the effectiveness of providing supported communication training and resources for health care providers in the stroke system is well documented, there is less evidence of implementation strategies for sustainable system change. This paper describes an implementation process targeting two specific areas: 1) improving Stroke Team communication with patients with aphasia, and 2) helping the Stroke Team provide support to families. The project aimed for practical sustainable solutions with potential contribution toward the development of an implementation practice model adaptable for other acute stroke contexts. The project was designed to create a communicatively accessible acute care hospital unit for people with aphasia. The process involved a collaboration between a Stroke Team covering two units/wards led by nurse managers (19 participants), and a community-based Aphasia Team with expertise in Supported Conversation for Adults with Aphasia (SCA™) – an evidence-based method to reduce language barriers and increase communicative access for people with aphasia. Development was loosely guided by the integrated knowledge translation (iKT) model, and information regarding the implementation process was gathered in developmental fashion over several years. Examples of outcomes related to the two target areas include provision of accessible information about aphasia to patients as well as development of two new products – a short virtual SCA™ eLearning module relevant to acute care, and a pamphlet for families on how to keep conversation alive. Potential strategies for sustaining a focus on aphasia and communicative access emerged as part of the implementation process. This implementation journey allowed for a deeper understanding of the competing demands of the acute care context and highlighted the need for further work on sustainability of communicative access interventions for stroke patients with aphasia and their families. [ABSTRACT FROM AUTHOR]

Speech-language pathologists (SLPs) are working with an increasing number of families from culturally and linguistically diverse backgrounds as the world's population continues to become more internationally mobile. The heterogeneity of these diverse populations makes it impossible to identify and document a one size fits all strategy for working with culturally and linguistically diverse families. This paper explores approaches to practice by SLPs identified as specialising in multilingual and multicultural practice in culturally and linguistically diverse contexts from around the world. Data were obtained from ethnographic observation of 14 sites in 5 countries on 4 continents. The sites included hospital settings, university clinics, school-based settings, private practices and Indigenous community-based services. There were 652 individual artefacts collected from the sites which included interview transcripts, photographs, videos, narrative reflections, informal and formal field notes. The data were analysed using Cultural-Historical Activity Theory ( Engeström, 1987 ). From the analysis six overarching Principles of Culturally Competent Practice (PCCP) were identified. These were: (1) identification of culturally appropriate and mutually motivating therapy goals, (2) knowledge of languages and culture, (3) use of culturally appropriate resources, (4) consideration of the cultural, social and political context, (5) consultation with families and communities, and (6) collaboration between professionals. These overarching principles align with the six position statements developed by the International Expert Panel on Multilingual Children's Speech (2012) which aim to enhance the cultural competence of speech pathologists and their practice. The international examples provided in the current study demonstrate the individualised ways that these overarching principles are enacted in a range of different organisational, social, cultural and political contexts. Tensions experienced in enacting the principles are also discussed. This paper emphasises the potential for individual SLPs to enhance their practice by adopting these overarching principles to support the individual children and families in diverse contexts around the world. [ABSTRACT FROM AUTHOR]

Stuttering may have a holistic effect on the quality of life of a person who stutters by limiting participation in social situations, resulting in feelings of isolation and frustration, leading to difficulties in education and employment and increasing the likelihood of mental health problems. Even young children who stutter may have negative experiences of speaking. Therefore, it is important to treat stuttering behavior effectively in both children and adults. The purpose of this paper was to systematically review group and case studies about the effectiveness of behavioral stuttering interventions to provide evidence-based guidelines for clinicians. Systematic data retrieval was conducted in four electronic databases (PsycINFO, CINAHL, PubMed, Cochrane). The assessment of search results was conducted according to predetermined inclusion and exclusion criteria by two independent judges. The methodological quality of each paper was assessed using strict criteria to include only high-quality research. The search revealed 2293 results, and 38 papers (systematic reviews N=3, group design studies N=21 and case studies N=14) with acceptable methodological quality were included. The data show that there is most evidence about the treatment of early childhood stuttering, very little evidence about school-aged children and some evidence about adults. The most convincing evidence is about the Lidcombe Program in the treatment of young children who stutter, but also other methods have promising evidence. Our data imply that in the treatment of adults who stutter, holistic treatments may influence speech fluency and overall experience of stuttering behavior. Speech restructuring treatments may have a positive effect on overt characteristics of stuttering, but not on covert stuttering behavior. The results of this review agree with earlier reviews about the treatment of young children. However, due to different inclusion criteria, this review also shows the benefits of holistic treatment approaches with adults and adolescents. [ABSTRACT FROM AUTHOR]

Many researchers have investigated the potential impact of breastfeeding in infancy on a child's subsequent development, but only a small subset of these studies considers language development and impairment. This paper reviews that literature, discussing postnatal neurodevelopment, potential mechanisms for dietary influences on communication outcomes, studies of typically developing children, and studies of children with communication concerns. For population based studies of language development, a modest but statistically robust relationship is seen across large samples that account for breastfeeding exclusivity. A similar protective relationship is seen in studies that evaluate the relationship between breastfeeding and language disorders; effect sizes are typically larger in these papers. Implications for researchers and service providers are reviewed. Learning outcomes : Readers will be able to describe possible mechanisms by which early diet might influence neurodevelopment. They will be able to describe the relationships observed between diet in infancy and language outcomes in large population-based studies, as well as the trends observed in studies of the relationship between infant diet and communication impairment. [ABSTRACT FROM AUTHOR]

Based on society's expectations of what defines the norms for what is deemed “masculine” and “feminine”, and a propensity for society's members to adhere to these expectations, women may face a unique set of circumstances and pressures following surgical treatment for laryngeal cancer. This is primarily due to the changes that occur to women's physical, psychological, and social functioning when dealing with cancer diagnosis and treatment outcomes. Because of concerns related to physical disfigurement, acoustic and perceptual changes to one's voice, and threat of the psychological sequelae associated with total laryngectomy (TL) (or, the surgical removal of one's voicebox and surrounding structures), there is an increased potential for violation of social expectations that cross these areas of functioning. As such, efforts that seek to better understand the potentially differential impact of TL on women and identify the specific needs they may have leading up to and after such treatment pursuant to contemporary societal expectations are warranted. Thus, this paper provides an examination of the potentially differential impact of TL on women. In addressing this position, this paper examines the unique challenges women may face postlaryngectomy through the framework of the International Classification of Functioning, Disability, and Health (ICF). Through the use of the ICF, this paper will provide an expanded perspective related to the interactions between body functioning, active participation in daily activities, and contextual factors that may act as facilitators or barriers to women's societal reintegration secondary to TL. Learning outcomes: Readers will be able to describe the multiple factors that may contribute to the differential impact of total laryngectomy (TL) on women. More specifically, readers will gain an understanding about women's physical, psychological, and social functioning secondary to TL. This paper also provides readers with exposure to the World Health Organization's International Classification of Functioning, Disability, and Health (ICF) framework. This framework provides readers with an expanded perspective related to the interactions between body functioning, active participation in daily activities, and contextual factors that may act as either facilitators or barriers to the societal reintegration of women secondary to TL. [ABSTRACT FROM AUTHOR]

Highlights • The typical FAS patient is a monolingual, right-handed female in her early 50 s. • Organic FAS is most often caused by stroke. • Lesions are typically in the premotor or motor cortex and in projections to these. • FAS is typically accompanied by aphasia, dysarthria and/or apraxia of speech. • Neurocognitive problems in FAS patients are variable. Abstract Foreign Accent Syndrome (FAS) is an intriguing motor speech disorder which has captured the interest of the scientific community and media for decades. At the moment, there is no comprehensive model which can account for the pathophysiology of this disorder. This paper presents a review of 112 FAS cases published between 1907 and October 2016: these were analyzed with respect to demographic characteristics, lesion location, associated neurocognitive symptoms, and comorbid speech and language disorders. The analysis revealed that organic-neurogenic FAS is more frequent in women than in men. In organic-neurogenic FAS over half of the patients acquired the foreign accent after a stroke. Their lesions are typically located in the left supratentorial regions of the brain, and generally involve the primary motor cortex and premotor cortex (BA 4 and 6), and/or the basal ganglia. Although neurocognitive data are not consistently reported, vascular FAS patients regularly suffer frontal executive dysfunctions. On the basis of a careful comparison of the cognitive and theoretical accounts of FAS, AoS and ataxic dysarthria, it is concluded that FAS should be regarded a dual component motor speech disorder in which both planning and motor execution of speech may be affected. [ABSTRACT FROM AUTHOR]

• Training Con-tAct, a Dutch communication partner training. • Changes in communicative behaviour and experiences in SLT students. • Improved conversation scores in supporting techniques. • SLT students may benefit from Training Con-tAct. • Improved access to health care, especially for communication vulnerable people. This paper describes the changes in communication skills, knowledge and confidence in Speech Language Therapy (SLT) students in conversations with People With Aphasia (PWA) after Training Con-tAct, a Dutch Communication Partner Training. On a voluntary basis, nine SLT students (2nd yr) completed Training Con-tAct, in which People With Aphasia (PWA) were involved as co-workers. A mixed method design with pre- and post-measures was used to analyze the students' communication skills, knowledge and confidence. A quantitative video analysis was used to measure changes in students' communication skills. Besides, a self-report questionnaire was used to measure the changes in students' knowledge and confidence regarding their communication with PWA. To evaluate the perspectives of the students on Training Con-tAct, additionally a focus group interview was held. Regarding students' communication skills the outcomes revealed a significantly higher score on the 'supporting' competence in students who took part in Training Con-tAct. The mean scores for the 'acknowledging' and 'checking information' competences did not improve significantly. The outcomes of the questionnaire showed students gained more knowledge and confidence regarding communication with PWA. The focus group interview provided insights into: motivation for participating in Communication Partner Training, content and structure of the training, feedback in CPT, and learning experiences. The present study suggests that SLT students may benefit from Training Con-tAct as the training leads to better skills, more knowledge about aphasia and more confidence in communicating with PWA. Training Con-tAct could be a valuable addition to the curricula of all healthcare disciplines, and eventually support interprofessional collaboration, resulting in improved access to health care, which is important for communication vulnerable people. Further research with a larger sample size and a control group is required. [ABSTRACT FROM AUTHOR]

• Sound level measuring apps may be used for audiometric calibration. • The performance of apps depends on the device and the external microphone. • Apps with flat frequency response can potentially be used to calibrate audiometers. • Methods are described to determine whether an app is suitable for calibration. • Correction factors are used to increase the accuracy of apps for calibration. Audiometric calibration, which includes the calibration of different audiometer transducers and the measurements of ambient noise levels, is historically carried out using Class 1 sound level meters. As technologies advance, many mobile applications (apps) have been developed to measure sound levels. These apps can provide alternative methods for audiometric calibration in places where sound level meters are not available, such as field testing environments, low-to-mid-income countries, and humanitarian settings. These apps, however, cannot be used for audiometric calibration without first evaluating their performance, which depends on multiple factors including the external components (if any), the operating system and the hardware of the electronic devices. The evaluation of the apps is actually the evaluation of the app and associated factors (i.e., the app systems). This paper discusses methods to assess several key functions of apps implemented in either Android or iOS operation system for audiometric calibration: 1) checking the measurement accuracy at all testing frequencies, 2) deriving and using correction factors, 3) determining the self-noise levels, and 4) evaluating the linear/measurement range. As audiometric calibration usually uses octave or 1/3 octave bands to measure sound pressure levels of tones and narrowband noises with relatively steady temporal characteristics, the accuracy of an app can be evaluated by comparing the levels measured by the app and a Class 1 sound level meter at each frequency. The level difference between the app and the Class 1 sound level meter at each frequency can then be used to calculate correction factors that can be added to subsequent levels measured by the app to improve its accuracy. In addition, methods to determine the self-noise level and the linearity range of apps are discussed. Sample measurement scenarios and alternative methods are provided to illustrate the evaluation process to determine whether an app is suitable for measuring ambient noise levels and for calibrating different audiometric transducers. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic disproportionately affected the health and well-being of marginalized communities, and it brought greater awareness to disparities in health care access and utilization. Addressing these disparities is difficult because of their multidimensional nature. Predisposing factors (demographic information, social structure, and beliefs), enabling factors (family and community) and illness levels (perceived and evaluated illness) are thought to jointly contribute to such disparities. Research has demonstrated that disparities in access and utilization of speech-language pathology and laryngology services are the result of racial and ethnic differences, geographic factors, sex, gender, educational background, income level and insurance status. For example, persons from diverse racial and ethnic backgrounds have been found to be less likely to attend or adhere to voice rehabilitation, and they are more likely to delay health care due to language barriers, longer wait times, a lack of transportation and difficulties contacting their physician. The purpose of this paper is to summarize existing research on telehealth, discuss how telehealth offers the potential to eliminate some disparities in the access and utilization of voice care, review its limitations, and encourage continued research in this area. A clinical perspective from a large volume laryngology clinic in a major city in northeastern United States highlights the use of telehealth in the provision of voice care by a laryngologist and speech-language pathologist during and after the COVID19 pandemic. [ABSTRACT FROM AUTHOR]

• This paper highlights data on Kuwaiti Arabic children with Down syndrome, which is an understudied population. • Results include both match and mismatch data of global measures of Whole Word Match, Word Shape Match, and Percent Consonant Match (including consonants in clusters). • Findings shed light on clinical practice for Kuwaiti Speech language pathologists. • This study is one of few studies in the Arab world that focuses on protracted phonological development. Studies on atypical phonological development are very limited for Arabic, and to date no studies on Arabic have investigated the development of phonology in children with conditions such as Down Syndrome. Arabic, like other Semitic languages, is rich in consonants and consonantal variation. However, it differs greatly from region to region, and so reports on individual dialects or regional dialects are necessary. Kuwaiti Arabic, the focus of the present paper, is similar to other dialects in the Gulf region. This is a preliminary study to examine the phonological development of school-aged Kuwaiti Arabic–speaking children with Down Syndrome in order to start to address the research gap noted above. Six Kuwaiti Arabic-speaking children were recruited for this pilot study from integrated public schools where children with disabilities and typically developing children are enrolled in the State of Kuwait: three male and three female students, age range of 5;10–12;3 years. All participants had the same single word speech test of 100 words. The first author, a native speaker of Kuwaiti Arabic, audio-recorded and phonetically transcribed the sample with the help of two speech-language pathologists from Kuwait. Reliability was confirmed by the first author and another expert rater. Both match and mismatch analyses were performed and compared to existing literature. Overall consonant accuracy across participants was 50%, with a variety of matches across consonant categories. However, the participants also exhibited a wide range of mismatches across positions in words and phonological features (place, manner, and laryngeal features). Place substitutions were the most frequent. Some sounds exhibited double (place and manner) mismatches. The most common word structure mismatch was consonant cluster reduction (no matches for word-initial clusters). Mismatch patterns resembled both those of normally developing Kuwaiti children and those of English speakers with Down Syndrome in certain ways. This pilot study provides preliminary information for clinicians regarding the speech or children with Down Syndrome (DS), not only in Kuwait but also in the Gulf region where there are similarities to Kuwaiti Arabic. [ABSTRACT FROM AUTHOR]

Highlights • Following TBI difficulties in pragmatic comprehension and production are detectable. • The paper investigates the relation between pragmatics, EF and ToM in TBI. • Increasing difficulty is exhibited in the pragmatic phenomena investigated. • ToM and EF have a limited role in explaining TBI pragmatic ability. Abstract Quality of life and social integration are strongly influenced by the ability to communicate and previous research has shown that pragmatic ability can be specifically impaired in individuals with traumatic brain injury (TBI). In addition, TBI usually results in damage to the frontotemporal lobes with a consequent impairment of cognitive functions, i.e., attention, memory, executive function (EF) and theory of mind (ToM). The role of the underlying cognitive deficits in determining the communicative-pragmatic difficulties of an individual with TBI is not yet completely clear. This study examined the relationship between the ability to understand and produce various kinds of communicative acts, (i.e., sincere, deceitful and ironic) and the above-mentioned cognitive and ToM abilities following TBI. Thirty-five individuals with TBI and thirty-five healthy controls were given tasks assessing their ability to comprehend and produce sincere, deceitful and ironic communicative acts belonging to the linguistic and extralinguistic scales of the Assessment Battery for Communication (ABaCo), together with a series of EF and ToM tasks. The results showed that, when compared to healthy individuals, participants with TBI performed poorly overall in the comprehension and production of all the pragmatic phenomena investigated, (i.e., sincere, deceitful and ironic communicative acts), and they also exhibited impaired performance at the level of all the cognitive functions examined. Individuals with TBI also showed a decreasing trend in performance in dealing with sincere, deceitful and ironic communicative acts, on both the comprehension and production subscales of the linguistic and extralinguistic scales. Furthermore, a hierarchical regression analysis revealed that – in patients with TBI but not in the controls – EF had a significant effect on the comprehension of linguistic and extralinguistic irony only, while the percentage of explained variance increased with the inclusion of theory of mind. Indeed, ToM had a significant role in determining patients' performance in the extralinguistic production of sincere and deceitful communicative acts, linguistic and extralinguistic comprehension of deceit and the linguistic production of irony. However, with regard to the performance of patients with TBI in the various pragmatic tasks investigated, (i.e., sincere, deceitful and ironic communicative acts), EF was able to explain the pattern of patients' scores in the linguistic and extralinguistic comprehension but not in production ability. Furthermore, ToM seemed not to be able to explain the decreasing trend in the performance of patients in managing the various kinds of communicative acts investigated. [ABSTRACT FROM AUTHOR]

Background In South Africa, many persons in need of augmentative and alternative communication (AAC) come from multilingual backgrounds. There is as yet a limited evidence base (locally and internationally) for the provision of AAC services to multilingual populations. The perspectives of service providers can assist in gaining an understanding of current practices and the factors that influence these. Aims The study aimed to obtain the perspectives of AAC service providers about practices in providing AAC systems and AAC intervention to clients from multilingual backgrounds. Methods & procedures Fifteen AAC service providers were purposefully chosen to participate in one of three focus groups – two face-to-face and one online focus group. Data from the face-to-face focus groups was transcribed verbatim. Thematic analysis was used to identify themes and subthemes in the data. Outcomes & results Four overarching themes were identified, namely (a) current practices, (b) factors influencing current practices, (c) service provides’ orientation towards different language options in AAC intervention, and (d) needs and desired developments regarding AAC technology. This paper reports on the first three themes. Service providers reported their practices to range from a focus on L1 exclusively, L2 exclusively, to a multilingual (sequential or simultaneous) approach. The South African language context, family language preferences and choices, service provider skill and knowledge, as well as AAC technology were identified as factors influencing their practices. Although many viewed access to multiple languages through AAC as positive, they also expressed concerns and reservations about providing multilingual AAC services. Conclusions & implications Although service providers in general saw the need to give clients from multilingual backgrounds access to multiple languages using AAC, this did not always translate into multilingual AAC practices. Both extrinsic factors (e.g. the lack of appropriate AAC devices, software and apps giving access to non-English languages) and intrinsic factors (service providers’ language competency and their beliefs about the cognitive demands of multilingual AAC systems) influenced their practices and choices. Appropriate AAC service delivery to multilingual populations in South Africa would require not only appropriate AAC technology developments, but also research evidence to establish the efficacy of multilingual AAC interventions for clients with a variety of characteristics. [ABSTRACT FROM AUTHOR]

Research suggests that transgender young offenders are a uniquely vulnerable caseload that may benefit from speech pathology intervention to help bring their voice into alignment with their gender identity. However, no previous studies have investigated treatment efficacy in this population. This study investigated the impact of intensive voice feminisation therapy targeting fundamental frequency and oral resonance in a 17 year old transgender individual within a youth justice institution. Acoustic analysis, listener and self-ratings of vocal femininity, self-ratings of vocal satisfaction, a post-treatment structured interview, and pre- and post- treatment completion of the Transsexual Voice Questionnaire (TVQ MtF ) were utilised to determine treatment impact. Outcome measures indicated therapy was effective at increasing the client’s vocal pitch and perceptually femininity without compromising vocal quality. However, the client was still not consistently perceived as female post-intervention and had difficulty implementing feminine speech strategies in discourse. This case study provides preliminary evidence for the effectiveness of intensive voice feminisation therapy in a youth offending population. This research also highlights the potential utility of speech pathologists working in youth justice settings, even when the timeframe for intervention is limited. Furthermore, this research paper validates the use of perceptual outcome measures in transgender voice work, by replicating previous findings in which significant correlations were found between perceptual ratings of vocal gender and client satisfaction. [ABSTRACT FROM AUTHOR]

There are policy and theoretical drivers for listening directly to children’s perspectives. These perspectives can provide insights to children’s experiences of their daily lives and ways in which they construct their multiple identities. Qualitative methodology is a useful research paradigm with regard to exploring children’s experiences. However, listening to the perspectives of children with speech and language disorders is a relatively new field of research. Therefore, it is important that researchers share their experiences of using methods and reflect on the strengths and limitations of these methods. The authors have used narrative inquiry with children with speech and language disorders to explore ways in which these children make sense of their experiences and construct their identities. In this paper, the authors reflect on methodological considerations when using narrative inquiry with children with speech and language disorders. They critically discuss three methodological considerations: narrative inquiry as a methodological choice, methods for data generation, limitations, and rigour. [ABSTRACT FROM AUTHOR]

Purpose This paper examines whether bilingual children with Specific Language Impairment (SLI) showed limited comprehension of Direct Object (DO) pronoun sentences and/or morphosyntactic priming compared to children with Typical Language Development (TLD) and adults. We analyzed the relation of these morphosyntactic processes to other psycholinguistic abilities, according to the MUC (Memory-Unification-Control) model. Method Ten bilingual native Spanish-speaking children with SLI (8;3–10;6) and 10 age-matched children with TLD (7;6–10;10) received a psycholinguistic evaluation in Spanish-English. The 20 children and 10 adults (19–34) performed an on-line cross-modal pronoun task. They listened to long distance animate DO pronoun sentences, and filler sentences without any pronoun. At the offset of the pronoun in each pronoun sentence, a picture of an animal for the antecedent (match condition), another animal for the second noun (mismatch), or an unrelated object (neutral) was displayed on the screen. In the filler sentences, a picture of an object that depicted the first noun, appeared at the offset of another later noun. Participants decided whether that pictured item was “alive”/“not alive” by pressing two keys on the computer keyboard. Immediately after, they answered an oral comprehension question about the DO pronoun sentence. Results Bilingual children with SLI showed significantly poorer comprehension of DO pronoun sentences than bilingual children with TLD. Pronoun sentence understanding in the overall children correlated significantly with oral sentence completion, expressive vocabulary abilities, auditory story comprehension, and the non-word repetition task, all in Spanish. Adults showed significantly the highest pronoun sentence comprehension, and the fastest animacy decisions across conditions; it was the only group showing a significant behavioral morphosyntactic priming effect. All groups exhibited high accuracy in the animacy decisions across conditions, although children with SLI showed lower accuracy and more variability. Conclusion Bilingual Spanish-English children with SLI showed significant limitations in understanding long distance animate DO pronoun sentences. The deficits were also related to weak morphosyntactic, lexical, and/or phonological representations stored in their memory. These processes may be harder to combine in the unification process, and also to control for answering the comprehension questions. Clinical and educational implications are discussed. [ABSTRACT FROM AUTHOR]

The Language ENvironment Analysis (LENA) System is a relatively new recording technology that can be used to investigate typical child language acquisition and populations with language disorders. The purpose of this paper is to familiarize language acquisition researchers and speech-language pathologists with how the LENA System is currently being used in research. The authors outline issues in peer-reviewed research based on the device. Considerations when using the LENA System are discussed. [ABSTRACT FROM AUTHOR]

• Meta-analysis examined prosody in autism, Williams syndrome, and Down syndrome. • Groups with autism struggled with prosodic form and emotional affect. • Groups with Williams syndrome struggled with prosodic form and phrase-level tasks. • The group with Down syndrome had the most difficulty, especially expressively. • No eligible studies of other etiologies of intellectual disability were found. Prosody, the rhythm and melody of speech, is an important component of effective communication, and it is an area of difficulty for many populations who struggle with communication. This paper is a meta-analysis of nine studies (and two sets of unpublished data) that assessed prosody using the Profiling Elements of Prosody in Speech-Communication (PEPS-C; Peppé & McCann, 2003) in autism spectrum disorder, Williams syndrome, and Down syndrome. Our original goal was to include studies involving any neurodevelopmental disorder that is commonly associated with intellectual disability, yet our systematic search, which included three databases (i.e., PsychInfo, ERIC, and PubMed), only identified studies involving these three groups. To be included in the meta-analysis, studies had to include a group (n ≥ 3 participants) with a neurodevelopmental disorder commonly associated with intellectual disability and a typically developing comparison group matched on chronological age, nonverbal abilities, or verbal abilities. Studies also needed to report original data using the PEPS-C and be available in English. Study quality was assessed using a checklist adapted from Downes et al. (2016). Results revealed that prosodic form was a weakness for each etiology, while unique patterns of strengths and weaknesses were evident for prosodic functions. Groups with autism (n = 5), all classified as high-functioning or with Asperger's syndrome, exhibited weakness in emotional affect but some relative strengths with turn-end and focus tasks. Groups with Williams syndrome (n = 4) demonstrated weaknesses on phrase/sentence-level tasks and relative strengths on word-level tasks. Groups with Down syndrome (n = 2) had the greatest difficulty overall, though performance was better on receptive (vs. expressive) function tasks. By combining studies and related subtasks of the PEPS-C, we are able to more confidently generalize findings for each population and identify targets for intervention. However, given the limited number of studies identified, this paper also highlights the need for more research on prosody in intellectual disability. [ABSTRACT FROM AUTHOR]

Background Aphasia is a common consequence of stroke. Despite receiving specialised training in communication, speech-language pathology students may lack confidence when communicating with People with Aphasia (PWA). This paper reports data from secondary outcome measures from a randomised controlled trial. Objective The aim of the current study was to examine the effects of communication partner training on the communication skills of speech-language pathology students during conversations with PWA. Method Thirty-eight speech-language pathology students were randomly allocated to trained and untrained groups. The first group received a lecture about communication strategies for communicating with PWA then participated in a conversation with PWA (Trained group), while the second group of students participated in a conversation with the PWA without receiving the lecture (Untrained group). The conversations between the groups were analysed according to the Measure of skill in Supported Conversation (MSC) scales, Measure of Participation in Conversation (MPC) scales, types of strategies used in conversation, and the occurrence and repair of conversation breakdowns. Results The trained group received significantly higher MSC Revealing Competence scores, used significantly more props, and introduced significantly more new ideas into the conversation than the untrained group. The trained group also used more gesture and writing to facilitate the conversation, however, the difference was not significant. There was no significant difference between the groups according to MSC Acknowledging Competence scores, MPC Interaction or Transaction scores, or in the number of interruptions, minor or major conversation breakdowns, or in the success of strategies initiated to repair the conversation breakdowns. Conclusion Speech-language pathology students may benefit from participation in communication partner training programs. [ABSTRACT FROM AUTHOR]

A primary feature of autism spectrum disorder (ASD) is marked difficulty in social interactions. Despite the centrality of social interaction differences to the clinical presentation of ASD, only a small portion of research in this field characterizes interaction in everyday social contexts. This theoretical paper reviews the growing corpus of interactional research on ASD, including discourse analysis (DA) and conversation analysis (CA) approaches. DA and CA are micro-analytic methods aimed at understanding the organizational structure of, and actions pursued within, social encounters. These methods are aligned with enactive theories of social interaction. The bulk of current ASD research construes social interaction as involving isolated individuals who represent and/or theorize about the minds of an interlocutor. Enactive approaches posit that achieving intersubjectivity does not require theories of other minds, but instead a propensity for coordinating social actions with others. Through the complementary lenses of enactivism and interactional research, I offer an account of autistic social interaction as involving differences in interactional coordination, interactional priorities, and the enactment of meaning across conversational turns. This characterization challenges the explanatory role of cognitive processes such as Theory of Mind, and points to new avenues for conceptualizing, measuring, and supporting social interaction. [ABSTRACT FROM AUTHOR]

Prosody serves central functions in language processing including linguistic functions (linguistic prosody), like structuring the speech signal. Impairments in production and comprehension of linguistic prosody have been described for persons with unilateral right (RHDP) or left hemisphere damage (LHDP). However, reported results differ with respect to the characteristics and severities of these impairments We conducted a systematic literature review focusing on production and comprehension of linguistic prosody at the prosody-syntax interface (i.e., phrase or sentence level) in LHDP and RHDP. In a systematic literature search we included: (i) empirical studies with (ii) adult RHDP and/or LHDP (iii) investigating production and/or comprehension of linguistic prosody at the (iv) phrase or sentence level (v) reporting quantitative data on prosodic measures. We excluded overview papers; studies involving participants with dysarthria, apraxia of speech, foreign accent syndrome, psychiatric diseases, and/or neurodegenerative diseases; studies focusing primarily on emotional prosody; and on lexical stress / word level; studies of which no full text was available and/or that were published in a language other than English. We searched the databases BIOSIS, MEDLINE, EMBASE, PubMed, Web of Science, CINAHL, Cochrane Library, PSYNDEX, PsycINFO and speechBITE, last searched on January 13th 2022.We found 2,631 studies without duplicates. We identified 43 studies which were included into our systematic review. For data extraction and synthesis of results, we grouped studies by (i) modality (production vs. comprehension), (ii) function (syntactic structure vs. information structure), and (iii) by experiment task. For production studies, outcome measures were defined as the productive use of the different prosodic cues (lengthening, pause, f0, amplitude). For comprehension studies, performance measures (accuracy and reaction times) were defined as outcome measures. In accordance with the PRISMA 2020 statement (Page et al., 2021), we conducted a quality check to assess study risk of bias. Our review was pre-registered with PROSPERO (CRD42019120308). Of the 43 studies reviewed, 30 studies involved RHDP (n = 309), assessing production in 15 studies and focusing on comprehension of prosody in 16 studies (one study investigated production and comprehension). LHDP (n = 438) were included in 35 studies of which 15 studied production and 21 evaluated comprehension of prosody (one study investigated production and comprehension). Despite the heterogeneity of results in the studies reviewed, our synthesis of results suggests that both LHDP and RHDP show limitations, but no complete impairment, in their production and/or comprehension of linguistic prosody. Prosodic limitations are evident in different areas of processing linguistic prosody, like syntactic disambiguation or the distinction between sentence types. There is a tendency towards more severe limitations in LHDP as compared to RHDP. We only included published studies into our review and did not perform an assessment of risk of reporting bias as well as systematic certainty assessments of the outcomes. Despite these limitations, we conclude that both groups show deficits in production and comprehension of linguistic prosody, but neither LHDP nor RHDP are completely impaired in their prosodic processing. This suggests that prosody is a relevant communicative resource for LHDP and RHDP worth being addressed in speech-language-therapy. [ABSTRACT FROM AUTHOR]

• International practitioner survey with over 4000 respondents. • Focus on parent/child interaction and Developmental Language Disorder. • Widespread adoption of parent/child interaction interventions evident across different professional groups. • Widespread involvement of fathers and other family members. • Some specific programmes named but detailed exploration of practice needed. The relationship between parental input and child language development has had a complex history. It has become clear that indirect parent training for the parents of children with delayed language development is an important feature of interventions offered by speech and language therapists in the anglophone countries. Yet we know less about how this type of approach is realised in other countries. In this paper we report the results of a survey of practice undertaken as part of the work of COST Action IS1406, a European Union (EU) funded research network. The focus of this paper is specifically on parent-related questions and responses referring to children under the age of twelve. The survey was devised by members of the Action and circulated electronically during the summer of 2017. In all, 4024 practitioners responded from 60 countries, the majority of whom came from EU member countries. Respondents to the survey indicated that indirect therapy is commonly carried out via the parent in the early years and via teachers later. A range of professional groups, in addition to speech and language therapists, is likely to adopt this approach; including teachers, pedagogues and psychologists. A variety of interventions is reported, some of which have a reasonable evidence-base underpinning them. It is interesting to see the widespread involvement of fathers and other family members in interventions. Finally, the fact that practitioner characteristics (age, experience, location of practice etc.) are not related to the use of indirect techniques points to the universal recognition of the value of these approaches. Despite the very different traditions in the practice of intervention across countries, there is clearly a widespread recognition of the importance of indirect approaches to intervention and specifically those focusing on parents. The mixture of family members being involved in interventions is a very promising indication of the role sharing commonly associated with the contemporary family. Yet the number of specific intervention approaches identified is relatively small given the number of respondents. There is a need for a better understanding of what exactly practitioners are doing when they involve parents in intervention or carry out parent-child interaction interventions and how well these interventions work in routine practice. This also has implications for the application of evidence-based practice and the precise nature of the interventions concerned (advice to parents, video interaction training etc.). [ABSTRACT FROM AUTHOR]

• •Values measures have typically been validated on older adults who has hearing loss. • •This paper examined the properties of the HHIE-S for older adults in Iran. • •Outcomes confirm the HHIE-S as a valid and reliable tool for assessing hearing in Persian. • •Further research and larger-scale replication studies are required on person with normal hearing. There is a great need for a valid hearing loss measurement tool in the Persian language to help identify hearing handicaps and potential communicational difficulties among Persian-speaking older adults. The present study aimed to validate and adapt the original English version of the Hearing Handicap Inventory for the Elderly (HHIE) into the Persian language. A tool development study was designed and data were collected from August to November 2019 in Tabriz, Iran among the older adults aged 60 years and above whose hearing loss had been confirmed by audiometry. The construct validity was assessed using Confirmatory Factor Analysis (CFA). The reliability of the tool was calculated by internal consistency and test-retest reliability. The statistical analysis was performed using SPSS 26.0 (SPSS and STATA 14). The CFA was conducted to examine the construct validity of the HHIE-S. According to the results, the model fit indices were acceptable (TLI = 0.93, CFI = 0.97, RMSEA = 0.07 (90% CI: 0.04 to 0.10), and SRMR = 0.03). Cronbach's alpha coefficient (0.85) and the test-retest reliability score (0.73) indicated good internal consistency. The results showed that HHIE-S is a valid and reliable tool for assessing hearing handicaps among Persian-speaking and Iranian older adults. [ABSTRACT FROM AUTHOR]

Purpose This study investigated the impact of providing low control (biological) and high control (psychobehavioral) causal explanations for stuttering on a variety of stigma related variables including blame, anger, social distance, stereotypes, dislike, sympathy, willingness to help, and perceptions of potential for recovery for a hypothetical person who stutters. Method One hundred and sixty-five university students read one of three vignettes describing a person who stutters with different descriptions about the cause of stuttering (low control, high control, and a control group in which no explanation was given) and answered a series of self-report measures assessing stigmatizing attitudes and perceived potential for recovery. Results The controllable explanation for stuttering led to more blame compared to the uncontrollable explanation and no explanation. The controllable explanation resulted in higher levels of anger and stereotypes compared to no explanation. There were no significant differences between uncontrollable explanations and no explanation on any of the stigma related variables of interest. Uncontrollable explanations increased prognostic pessimism compared to controllable explanations. Self-reported familiarity and closeness with people who stutter was significantly related to more positive attitudes toward a hypothetical person who stutters. Conclusions Reducing the belief that stuttering is ultimately caused by psychobehavioral factors will reduce blame toward people who stutter. However, providing biological explanations for stuttering is not effective for reducing stigma compared to no explanation at all, and could increase prognostic pessimism. Biological explanations for stuttering should be provided to inform clients and society about current research findings, however this information must be given carefully and be balanced with evidence that people who stutter can make great progress with appropriate, personalized therapy that addresses the multidimensionality of the disorder. Learning outcomes As a result of reading this paper, readers should be able to: (1) describe how causal attributions impact attitudes toward individuals with disabilities (2) summarize the effects of providing a biological explanation for stuttering on stigmatizing attitudes toward a person who stutters (3) summarize the effects of providing a psychobehavioral explanation for stuttering on stigmatizing attitudes toward a person who stutters, (4) discuss how familiarity and closeness toward people who stutter relates to stigmatizing attitudes toward a person who stutters. [ABSTRACT FROM AUTHOR]

Background Peer Mediated Interventions (PMIs) can be incorporated into integrated early childhood and preschool settings to address socialization impairments observed in children with ASD ( Katz & Girolametto, 2013 ). However, research examining specific PMI strategies with young preschoolers remains limited. Objective The current study examines the efficacy of the Stay, Play, Talk PMI ( English, Shafer, Goldstein, & Kaczmerek, 1997 ) on the social communication skills of young preschool children diagnosed with an Autism Spectrum Disorder (ASD). Method Each of 3 typically developing children (ages 3–5 years) was paired with a child with an ASD (ages 3–4 years). Typically developing peers were taught to Stay with their friend, Play with their friend, and Talk to their friend. The child dyads played together during two, 20-min weekly sessions for 6–8 weeks. A multiple baseline design across participants was implemented to measure the impact of the Stay Play Talk strategies on social initiations and responses characterized by non-coordinated gestures, gestures, and words. Simulation Modeling Analysis was also conducted to confirm visual analysis. Results All 3 typical peer buddies and all 3 target children with ASD demonstrated increases in the frequency of their responses, reaching levels that greatly exceeded baseline levels. Further, social reciprocations increased among each dyad above baseline. Social initiations remained variable across dyads. Gains were not maintained two months post intervention. Conclusion Results of this study corroborated previous findings that support the usefulness of PMIs to improve social communication of young children with ASD ( Chan et al., 2009 ) and suggest an economical, naturally occurring approach to improve social communication during early childhood. Learning outcomes: Readers will gain knowledge regarding the social communication profile of children with ASD and how this profile can negatively impact language development and peer relationships. In addition, readers will be able to identify the basic components of the Stay Play Talk intervention. Finally, this paper will explain the impacts of the Stay Play Talk intervention on the social communication skills of young children with ASD. [ABSTRACT FROM AUTHOR]

Two recent studies from Australia and Germany have both shown that people who stutter (PWS) have elevated Neuroticism scores on the widely used NEO Five Factor Inventory (NEO-FFI) compared to individuals in a control sample. The two studies showed opposite results, however, for the personality traits Agreeableness and Conscientiousness. One reason for these opposing findings could be that the two studies were conducted in different cultural settings. Given that the effect of different cultural background on the relationship between the NEO-FFI and stuttering remains an open question, we investigated the NEO-FFI scores from 98 PWS and an age- and sex-matched control-group from a less widely studied cultural background (Iran). Overall, the present study showed, in line with a study from Germany, higher Agreeableness, but not Neuroticism, in PWS compared to normally fluent controls. To get further insights into these findings, we also contrasted both samples from Iran with a healthy matched sample from Germany. The resulting cross-cultural differences from these analyses are also discussed in the present paper. Although the present study is limited by a cross-sectional design, and so no causal conclusions can be drawn, the authors discuss whether the replicated elevated Agreeableness scores in PWS might represent a self-defense mechanism to cope with one's own speech handicap. [ABSTRACT FROM AUTHOR]

• Organizations need empirical data to inform service delivery and resource allocation decisions. • Assessment tools co-developed with clinicians can be usable and useful in practice and research. • By engaging clinicians, the barriers to implementing new assessment tools can be understood. • The Profile of Preschool Communication can support clinical data collection across large programs. . This study aimed to pilot test, assess usability and utility of, and identify barriers to implementation for the Profile of Preschool Communication (PPC) - a new data collection tool designed to support outcome monitoring in preschool speech-language programs and practice-based research.. This pilot study was conducted with three sites in the Ontario Preschool Speech and Language (PSL) program. Twenty-three speech-language pathologists used the PPC for all outcome monitoring assessments for 2–3-months and provided feedback about their experience using it in practice. Then, 18 of the 23 speech-language pathologists completed online surveys to rate usability and utility, and report their perceived implementation barriers and facilitators.. Speech-language pathologists reported difficulties completing some sections of the PPC, most notably obtaining data related to maternal education and family history of mental health concerns. Usability and utility were generally rated favorably with some items rated as neutral. Barriers to implementation included the paper format, completion time, requirement to ask personal questions, and the perception by some that data were useful for outcome monitoring but not practice. Facilitators included ease of use, an improvement over the existing tool, and the collection of data to support service planning.. The PPC shows potential as an outcome monitoring data collection tool in preschool speech-language pathology programs. Findings will be of interest to researchers engaged in practice-based research and those interested in engaging end users to develop clinically meaningful tools. [ABSTRACT FROM AUTHOR]

• Disparities in social determinants of health impair access to aphasia care. • Hispanic bilinguals with aphasia are underrepresented in clinical research. • Teletherapy may readily connect Hispanic clients with bilingual service providers. • Bilingual assessments and treatments can be modified for virtual administration. • Traditional approaches to aphasia care must be adjusted for health disparities. Disparities in social determinants of health (SDOH) such as socioeconomic status and access to quality healthcare present serious barriers to enrollment in clinical rehabilitation programs for individuals who have experienced a stroke, especially for those who identify with a racial-ethnic minority group. Hispanic bilinguals with aphasia (HBWA) are one marginalized group who face even greater enrollment challenges since post-stroke language impairment and limited English proficiency make it difficult to advocate for one's needs and identify appropriate rehabilitation programs. Given the increasing representation of Hispanic individuals in the U.S. (projected to be 30% of the population in 2050), it is imperative that clinicians counter disparities in stroke care by facilitating access to clinical services for HBWA. However, the Hispanic population remains largely understudied in the stroke and aphasia literature, due in part to reduced opportunities to enroll in large-scale clinical research studies. In this paper we highlight how our team at Boston University has designed and implemented a variety of recruitment practices, assessment modifications, and treatment accommodations to circumvent the known barriers to participation in clinical research experienced by HBWA. Furthermore, we discuss the importance of cultural responsiveness and demonstrate how including principles of sensitivity and humility in clinical trial protocols improves participant enrollment and retention. Although clinical adjustments in this study were developed for use with HBWA, the effectiveness of the procedures suggests they may be useful blueprints for expanding access to research opportunities for various marginalized groups. [ABSTRACT FROM AUTHOR]

Individuals with multiple sclerosis (MS) are at risk for communication problems that may restrict their ability to take participation in important life roles such as maintenance of relationships, work, or household management. The aim of this project is to examine selected demographic and symptom-related variables that may contribute to participation restrictions. This examination is intended to aid clinicians in predicting who might be at risk for such restrictions and what variables may be targeted in interventions. Community-dwelling adults with MS ( n = 216) completed a survey either online or using paper forms. The survey included the 46-item version of the Communicative Participation Item Bank, demographics (age, sex, living situation, employment status, education, and time since onset of diagnosis of MS), and self-reported symptom-related variables (physical activity, emotional problems, fatigue, pain, speech severity, and cognitive/communication skills). In order to identify predictors of restrictions in communicative participation, these variables were entered into a backwards stepwise multiple linear regression analysis. Five variables (cognitive/communication skills, speech severity, speech usage, physical activity, and education) were statistically significant predictors of communication participation. In order to examine the relationship of communicative participation and social role variables, bivariate Spearman correlations were conducted. Results suggest only a fair to moderate relationship between communicative participation and measures of social roles. Communicative participation is a complex construct associated with a number of self-reported variables. Clinicians should be alert to risk factors for reduced communicative participation including reduced cognitive and speech skills, lower levels of speech usage, limitations in physical activities and higher levels of education. Learning outcomes: The reader will be able to: (a) describe the factors that may restrict participation in individuals with multiple sclerosis; (b) list measures of social functioning that may be pertinent in adults with multiple sclerosis; (c) discuss factors that can be used to predict communicative participation in multiple sclerosis. [ABSTRACT FROM AUTHOR]

The purpose of this report is to describe an initial version of the Apraxia of Speech Rating Scale (ASRS), a scale designed to quantify the presence or absence, relative frequency, and severity of characteristics frequently associated with apraxia of speech (AOS). In this paper we report intra-judge and inter-judge reliability, as well as indices of validity, for the ASRS which was completed for 133 adult participants with a neurodegenerative speech or language disorder, 56 of whom had AOS. The overall inter-judge ICC among three clinicians was 0.94 for the total ASRS score and 0.91 for the number of AOS characteristics identified as present. Intra-judge ICC measures were high, ranging from 0.91 to 0.98. Validity was demonstrated on the basis of strong correlations with independent clinical diagnosis, as well as strong correlations of ASRS scores with independent clinical judgments of AOS severity. Results suggest that the ASRS is a potentially useful tool for documenting the presence and severity of characteristics of AOS. At this point in its development it has good potential for broader clinical use and for better subject description in AOS research. Learning Outcomes: The Apraxia of Speech Rating Scale: A new tool for diagnosis and description of apraxia of speech 1. The reader will be able to explain characteristics of apraxia of speech. 2. The reader will be able to demonstrate use of a rating scale to document the presence and severity of speech characteristics. 3. The reader will be able to explain the reliability and validity of the ASRS. [ABSTRACT FROM AUTHOR]

• Expansion points intervention (EXP) has 25 required intervention elements. • EXP aligns with the Phonological Intervention Taxonomy domains. • The flexibility and distinctiveness of EXP is comparable to other interventions. The Phonological Intervention Taxonomy (Baker, Williams, McLeod, & McCauley, 2018) was developed on the basis of cataloguing the elements of 15 phonological interventions in the domains of the goal of intervention, the teaching moment, the context (who provides the intervention and where it is provided), and procedural issues. Additionally, three summary measures are computed from the tallying of elements in the taxonomy: concentration (the number of required plus optional elements, with a maximum of 72; flexibility (the number of optional elements compared to the total present for the intervention), and distinctiveness (the number of rare elements plus the number of common elements that are absent). In the present paper, the taxonomy is applied to a novel intervention called Expansion Points Intervention (EXP; Smit, Brumbaugh, Weltsch, & Hilgers, 2018) in order to (a) determine how well the taxonomy captures elements of EXP, and (b) compare EXP to other phonological interventions. The four domains of the taxonomy were systematically applied to EXP to determine which elements were required, optional, or not relevant to the implementation of EXP, using the definitions supplied with the taxonomy. Of the 72 elements in the taxonomy, 25 were considered required elements in EXP and 15 were considered to be optional, resulting in a concentration of 40 and a flexibility of 37.5 %, both of which were in the lower part of the range for the 15 comparison interventions. By way of contrast, distinctiveness , at 15 % was at the high end of the range. Based on the ease with which EXP aligns with elements of the taxonomy, the taxonomy was readily applied to EXP. EXP appeared to be comparable to the 15 original interventions, which means that the principles underlying EXP resemble those of other interventions. The implications of these findings for a theory of therapeutic intervention for phonological disorders are discussed. [ABSTRACT FROM AUTHOR]

• Natural metalinguistic skills in people with dementia in the early stages of the disease were assessed. • A sample of 180 people was selected: 60 had Alzheimer's disease, 60 had frontotemporal dementia and 60 healthy individuals. • A 40-item test (MetAphAs), consisting of six different sections, was used to evaluate metalinguistic skills. • Statistically significant differences were observed when comparing people with dementia and controls. • Significant differences were observed among subgroups of people with dementia, in most sections of the test. The aim of this paper is to assess whether the use of natural metalinguistic skills can be used to differentiate linguistic-communicative profiles of people with dementia (Alzheimer's disease and frontotemporal dementia in the behavioural and primary progressive aphasia variants) in the earliest stages of the disease. A sample of 180 people was selected. Sixty had Alzheimer's disease, 20 had frontotemporal dementia of the behavioural variant, and 40 had frontotemporal dementia of the primary progressive aphasia variant (20 had non-fluent primary progressive aphasia and 20 had semantic dementia). The control group was composed of 60 healthy people with ages, gender, and professions as similar as possible to those of the people in the dementia groups. All the participants were administered the Spanish adaptation of the Mini-Mental State Examination (MMSE) and the Global Deterioration Scale (GDS) to assess dementia severity. To assess the use of natural metalinguistic skills, a 40-item test (MetAphAs), specifically designed for this aim, was administered. The test showed high internal validity and high positive correlations with the MMSE. Statistically significant differences were observed in the total scores on this test and in the scores on each of its sections, when comparing the whole group and the subgroups of people with dementia with the control group. Additionally, the scores on most of the sections of the MetAphAs test presented statistically significant differences when the different subgroups of people with dementia were compared. A test like the MetAphAs, specifically designed to assess natural metalinguistic abilities, may be useful for obtaining differential communicative-linguistic profiles according to the type of dementia in the early stages of the disease. However, additional research is needed to obtain more conclusive results. [ABSTRACT FROM AUTHOR]

• Primary-school learners with DLD develop foreign language skills very slowly. • Children with DLD learn vocabulary faster if they start EFL lessons at an older age. • L1 vocabulary predicts EFL vocabulary size in children with TLD and DLD. • Children with DLD have less informal exposure to English outside of classroom. There is a growing pressure to teach foreign languages as early as possible, and children with Developmental Language Disorder (DLD) are not immune from these pressures. However, current scholarship lacks crucial insights into how children with DLD respond to L2 learning with minimal (classroom) exposure. In this paper, we report the results of a longitudinal study tracing the development of L1 Russian and English as a Foreign Language (EFL) skills in a group of learners with DLD (age of EFL onset: 7;9–12;1). The performance of the DLD group was compared to that of typically-developing controls, matched for classroom EFL exposure. Proficiency in English and Russian was measured three times (after one, one-and-a-half and two years of EFL instruction). At Time 1, there were no significant differences between groups on the EFL measures, but the performance of the typically-developing children significantly improved with time, and that of the DLD group did not. In the DLD group, age of EFL onset was positively related to English receptive vocabulary size. The relation between L1 and L2 proficiency in the DLD group was weaker than in the comparison group. This pattern is probably due to the floor performance of the DLD group in the grammatical domain, but may also indicate that the disorder affects cross-language transfer in the vulnerable domains. [ABSTRACT FROM AUTHOR]

• Children with HFA have impairment in emotional prosody recognition. • Intensity increase did not improve children with HFA's overall emotion recognition. • Children with HFA have difficulty discriminating between emotions differing in valence. • Children with HFA have difficulty discriminating between emotions differing in arousal. This paper investigated the ability of Mandarin-speaking children with high-functioning autism (HFA) to recognize the four categories of emotional prosody, namely, happiness , anger , sadness and fear , in moderate- and high-intensity emotional conditions using auditory discrimination tasks. Thirty-four children with HFA between 5 and 7 years of age and 34 typically developing (TD) controls participated in this study. In moderate-intensity conditions, children with HFA scored lower than TD children in the recognition of the four categories of emotional prosody, indicating an overall impairment. With an increase in the intensity of emotion, children with HFA showed improved accuracy for anger, decreased accuracy for happiness, but no change in accuracy for either sadness or fear. An analysis of error patterns demonstrated that unlike TD children, children with HFA were inclined to mistake happiness for anger, with the two categories differing in valence, and this inclination deepened as the intensity increased. In discriminating between sadness and fear, which have a slight arousal difference, both groups showed difficulty in moderate-intensity conditions. In high-intensity conditions, TD children were inclined to perceive stimuli as exhibiting fear, which demonstrates comparatively high arousal; thus, they were more accurate for fear, while HFA children were not sensitive to increases in arousal, showing no noticeable effect. These findings indicated that children with HFA have a mechanism distinct from that of TD children in emotional prosody recognition, exhibiting various degrees of impairment in this regard. [ABSTRACT FROM AUTHOR]

• International review of language and auditory processing skills in the cleft palate population. • Poorer outcomes in language and auditory processing compared with non-cleft peers. • Scores on standardized tests of language frequently fall within the normal range. • Limited correlations of skills in speech, language and auditory processing. • Lack of longitudinal data and comparison to other communication disorders. Cleft lip and/or palate (CL/P) is the most common congenital craniofacial condition. Children born with CL/P are at increased risk of persistent speech difficulties related to velopharyngeal incompetence (VPI) and compensatory articulation problems. It has also been reported that they achieve poorer results academically than their peers. There is a further body of evidence to suggest delayed language skills. These potentially related outcomes are often reported separately. To review published and unpublished research into the nature of difficulties related to spoken and written language across all non-syndromic cleft diagnoses. To review any evidence of associations between comorbidities. A scoping review was carried out in October 2016 and updated in June 2019 following published methodology (Arksey & O'Malley, 2005; Levac et al. 2010). A search of the literature over the two time points found 38 papers in total. Three main themes were found: oral language skills, reading and auditory processing difficulties. There is evidence of early language delay in children born with CL/P. Evidence of persistent oral language problems is less conclusive. Many studies have reported scores within the average range for language, auditory processing and reading but poorer outcomes when compared to non-cleft control groups. However, studies have used a range of outcome measures, making comparisons difficult. Moreover there is no clear evidence how these difficulties might relate to speech outcomes or educational achievement and no comparison to other populations with speech, language and communication needs (SLCN). [ABSTRACT FROM AUTHOR]

• Hearing devices are not able to fully restore speech perception in background noise. • Gestures combined with visual speech cues enhance degraded speech comprehension. • Individuals modify gestures dependent on context and environment. • The impact of hearing loss on audience design of gesture and gaze is unexplored. • Aural rehabilitation might be enhanced with evidence-based gesture intervention. Nonverbal communication, specifically hand and arm movements (commonly known as gesture), has long been recognized and explored as a significant element in human interaction as well as potential compensatory behavior for individuals with communication difficulties. The use of gesture as a compensatory communication method in expressive and receptive human communication disorders has been the subject of much investigation. Yet within the context of adult acquired hearing loss, gesture has received limited research attention and much remains unknown about patterns of nonverbal behaviors in conversations in which hearing loss is a factor. This paper presents key elements of the background of gesture studies and the theories of gesture function and production followed by a review of research focused on adults with hearing loss and the role of gesture and gaze in rehabilitation. The current examination of the visual resource of co-speech gesture in the context of everyday interactions involving adults with acquired hearing loss suggests the need for the development of an evidence base to effect enhancements and changes in the way in which rehabilitation services are conducted. [ABSTRACT FROM AUTHOR]

• Priming and cueing serve to pre-engage the neural system by triggering the retrieval of linked conceptual knowledge. • Differences between priming and cueing are linked to timing and conscious intentional engagement. • Semantic Feature Analysis and Verb Network Strengthening Treatment are two priming based treatments used to enhance linguistic performance. The behavioral effects of lexical priming are well studied in the cognitive sciences. Clinical use of the term and widespread implementation of priming based behavioral interventions has remained limited. This is despite the fact that response-contingent cueing, a behavioral intervention technique used during many cognitive-linguistic interventions, is grounded in theories of priming research. The aim of this manuscript is to connect behavioral performance changes observed following priming with those noted following cueing, providing a theoretical rationale for the therapeutic use of both priming and cueing in language and cognitive interventions. In this review, we establish a conceptual basis for how both primes and cues serve to pre-engage the neural system by triggering the retrieval of linked conceptual knowledge, resulting in faster and more accurate responses. Differences between the two (primes and cues) have been linked to timing and conscious intentional engagement, though these distinctions are often task dependent. Additionally, this paper will provide evidence of the clinical utility of priming. Studies of priming in adults with acquired brain injuries are discussed and clinical interventions based on theories of priming are examined. Furthermore, the present work will briefly detail the inhibitory effects of priming to aid clinicians and researchers in deciding how to pair primes and cues with intended retrieval targets. In summation, the present work is intended to bridge two related fields providing both theoretical and clinical insight with respect to the use of primes and cues. [ABSTRACT FROM AUTHOR]

In this paper we discuss the relationship between the proceduralization process and cognitive control. Our discussion is based on theoretical models and clinical practices, with a focus on child language impairment. We argue that the same skill may require more or less cognitive control depending on the differences in contextual conditions. [ABSTRACT FROM AUTHOR]

• Techniques for late spontaneous recovery from stuttering clustered into six strategies. • The strategies reflect components of established treatments and naïve explanations. • Causal attributions of recovery clustered into three implicit theories about recovery. • Knowledge about strategies and implicit theories may help to improve treatment. (1) To survey the employed techniques and the reasons/occasions which adults who had recovered from stuttering after age 11 without previous treatment reported as causal to overcome stuttering, (2) to investigate whether the techniques and causal attributions can be reduced to coherent (inherently consistent) dimensions, and (3) whether these dimensions reflect common therapy components. 124 recovered persons from 8 countries responded by SurveyMonkey or paper-and-pencil to rating scale questions about 49 possible techniques and 15 causal attributions. A Principal Component Analysis of 110 questionnaires identified 6 components (dimensions) for self-assisted techniques (Speech Restructuring; Relaxed/Monitored Speech; Elocution; Stage Performance; Sought Speech Demands; Reassurance; 63.7% variance explained), and 3 components of perceived causal attributions of recovery (Life Change, Attitude Change, Social Support; 58.0% variance explained). Two components for self-assisted techniques (Speech Restructuring; Elocution) reflect treatment methods. Another component (Relaxed/Monitored Speech) consists mainly of items that reflect a common, non-professional understanding of effective management of stuttering. The components of the various perceived reasons for recovery reflect differing implicit theories of causes for recovery from stuttering. These theories are considered susceptible to various biases. This identification of components of reported techniques and of causal attributions is novel compared to previous studies who just list techniques and attributions. The identified dimensions of self-assisted techniques and causal attributions to reduce stuttering as extracted from self-reports of a large, international sample of recovered formerly stuttering adults may guide the application of behavioral stuttering therapies. [ABSTRACT FROM AUTHOR]