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Augmentative and alternative communication (AAC) approaches offer expressive and receptive supports for the segment of the population of individuals with autism spectrum disorder (ASD) who have little or no functional speech. The National Center for Autism Evidence and Practice (NCAEP) declared augmentative and alternative communication (AAC) interventions for individuals with autism an "evidence-based practice." Following a brief analysis of the breakdown of studies included in NCAEP by dependent variable, we introduce each of the four papers published as part of this special issue on Advances in Augmentative and Alternative Communication Research for Individuals with Autism Spectrum Disorder. In addition to elucidating the contributions and advances of each paper to the research base, including the NCAEP report, we provide a critical commentary as applicable in the hopes of stimulating and guiding further research. [ABSTRACT FROM AUTHOR]

Communication partner training is a recommended intervention for partners of people with acquired brain injury. In this paper we explore the past, present, and future of communication partner training (CPT) based on our 2023 Speech Pathology Australia national conference address. We focus on our research team's contributions, and highlight research knowledge across stroke, traumatic brain injury (TBI), and dementia. This work is anchored in the voice of people with communication disability. One partner in the CPT journey, Rosey Morrow, co-authors this paper. The CPT evidence base for acquired neurological conditions is growing, including in the areas of technology, co-design, and translation. However, knowledge and implementation gaps remain. The future of CPT will require us to harness co-design and technology, whilst meeting the implementation challenges of complex systems to enable communication for all. [ABSTRACT FROM AUTHOR]

Communication between patients and clinicians influences the development of therapeutic relationships. Communication is disrupted when the patient has communication impairments after stroke. However, how these communication disruptions influence therapeutic relationships is not well-understood. This qualitative metasynthesis explores the perspectives of people with communication impairment to understand how interpersonal communication influences therapeutic relationships. Four databases were searched for qualitative studies which discussed how communication influenced therapeutic relationships from the perspectives of people with aphasia, dysarthria or apraxia of speech. Additional papers were identified through citation searching and subject experts. Nineteen eligible papers were included and analysed using thematic analysis. Four themes were constructed from the analysis: (1) Relationships provide the foundation for rehabilitation; (2) Different relational possibilities arise from "reading" the clinician; (3) Creating therapeutic relationships through validating interactions and connections; and (4) Creating therapeutic disconnections through invalidating, exclusionary interactions. A therapeutic relationship develops, at least in part, in response to the clinician's communication and how this is received and experienced by the patient. Understanding the characteristics of relationship-fostering communication and knowing how communication influences relationships can help clinicians critically reflect on their communication and better develop therapeutic relationships with people with communication impairment. Practitioner-patient communication can facilitate therapeutic relationships or create therapeutic disconnections. Communication patterns that are commonly evident when a patient has communication impairments can impede therapeutic relationships. Clinicians need to attend to how their communication is received and how it influences people's sense of self. Communication partner training should address the existential and relational needs of people with communication impairment after stroke. [ABSTRACT FROM AUTHOR]

Background: Symbol communication aids are used by children with little or no intelligible speech as an Augmentative and Alternative Communication strategy. Graphic symbols are used to help support understanding of language and used in symbol communication aids to support expressive communication. The decision making related to the selection of a symbol communication aid for a child is poorly understood and little is known about what language and communication attributes are considered in this selection. Aim: To identify from the literature the language or communication attributes of graphic symbol communication aids that currently influence AAC practice. Method and Procedure: A search strategy was developed and searches were performed on a range of electronic databases for papers published since 1970. Quality appraisal was carried out using the CCAT tool and papers rated as weak were not included in the review. Results: Eleven studies were included in the review reporting data from 66 participants. Weaknesses were identified in most studies that would limit the validity of the results for application to practice. Included studies investigated aspects of vocabulary organization and design, the process of vocabulary selection, and the choice of the symbol system and encoding method. Two studies also evaluated innovative communication aid attributes. Conclusions: Information from studies reported in the research literature provides a sparse source of information about symbol communication aids from which clinicians, children or family members may make informed decisions. This review is the first to systematically appraise the literature to answer the question what evidence exists to inform clinical decision making in relation to the language or communication attributes of graphic symbol based communication aids? The review establishes that there is a paucity of evidence from studies and that these decisions must thus be based on other information and factors. The review does establish a small number of language or communication attributes of symbol communication aids, but no synthesis of the results of these studies was possible. This review thus suggests that vocabulary design and organization, symbol system and encoding method, and the choice of vocabulary selection method are attributes that clinicians may carefully review in order to inform decisions. Clinicians encountering symbol vocabulary packages claiming to be 'evidence based' should query the nature of this evidence. The rehabilitation research community should debate and develop appropriate research designs that will facilitate future robust studies investigating the effect of specific language or communication attributes of communication aids. [ABSTRACT FROM AUTHOR]

The 2030 Agenda for Sustainable Development identifies the need for inclusive societies and justice for people who experience, or are at risk of experiencing, modern slavery. The primary objective of this commentary paper is to consider current research and practice in relation to the protection of people with communication disability from modern slavery. The paper considers the role of SLPs in developing and disseminating accessible information to help achieve decent work and economic growth (SDG 8) and peace, justice, and strong institutions (SDG 16). This paper considers five areas for protecting people with communication disability from modern slavery: (1) accessible information, (2) advocacy, (3) rights-based approaches, (4) improved understanding about access to services, and (5) education. Practice examples are discussed across each of these areas, with a focus on accessible information. This commentary asserts that information about modern slavery must be accessible so that people with communication disability experience inclusion, safety, and justice. SLPs are well placed to implement communication strategies, such as accessible information, to help protect people with communication disability from modern slavery. This commentary paper focuses on SDG 8 and SDG 16 and also addresses SDG 1, SDG 3, SDG 4 and SDG 10. [ABSTRACT FROM AUTHOR]

Colonisation and continuing discrimination have significantly and negatively impacted the physical, social and emotional wellbeing of First Nations peoples globally. In Australia, Aboriginal cultures thrive despite ongoing barriers to health care. This paper describes challenges and new initiatives for Australian Aboriginal people with acquired communication disability after brain injury and their alignment with the global aims forming the Sustainable Development Goals. Research undertaken by an Aboriginal and non-Aboriginal multidisciplinary team over a decade in Western Australia identified and responded to mismatches between community needs and services. Initiatives described include the Missing Voices, Healing Right Way, Brain Injury Yarning Circles and Wangi/Yarning Together projects. Recommendations implemented related to (a) greater incorporation of Aboriginal cultural protocols and values within services, (b) more culturally secure assessment and treatment tools, (c) support after hospital discharge, (d) Aboriginal health worker involvement in support. Implementation includes cultural training of hospital staff, trialling new assessment and treatment methods, and establishing community-based Aboriginal Brain Injury Coordinator positions and relevant peer support groups. Culturally secure brain injury rehabilitation in Australia is in its infancy. Our initiatives challenge assumptions about worldviews and established Western biomedical models of healthcare through incorporating Indigenous methodologies and leadership, and community-driven service delivery. This commentary paper focuses on Sustainable Development Goals 3, 16 and 17. [ABSTRACT FROM AUTHOR]

This paper explores the challenge of establishing a meaningful connection between a neurotypical therapist and a neurodiverse patient who inhabit different Umwelts, that is, perceptual worlds.1 It discusses how addressing anxiety is crucial in preventing communication difficulties from escalating for individuals with autism who may have heightened stress due to an overgrown amygdala. Embodied mirroring is introduced to focus on perceptions and reduce stress. Furthermore, the potential for epigenetic changes due to unaddressed anxiety is raised. The paper emphasises the importance of responding to individual differences in sensory and perceptual experiences to promote effective communication and positive outcomes in therapy. [ABSTRACT FROM AUTHOR]

Artificial intelligence (AI) is expected to impact all facets of inflammatory bowel disease (IBD) management, including disease assessment, treatment decisions, discovery and development of new biomarkers and therapeutics, as well as clinician–patient communication. This perspective paper provides an overview of the application of AI in the clinical management of IBD through a review of the currently available AI models that could be potential tools for prognosis, shared decision-making, and precision medicine. This overview covers models that measure treatment response based on statistical or machine-learning methods, or a combination of the two. We briefly discuss a computational model that allows integration of immune/biological system knowledge with mathematical modeling and also involves a 'digital twin', which allows measurement of temporal trends in mucosal inflammatory activity for predicting treatment response. A viewpoint on AI-enabled wearables and nearables and their use to improve IBD management is also included. Although challenges regarding data quality, privacy, and security; ethical concerns; technical limitations; and regulatory barriers remain to be fully addressed, a growing body of evidence suggests a tremendous potential for integration of AI into daily clinical practice to enable precision medicine and shared decision-making. Advances in artificial intelligence (AI) show promise for improving treatment response prediction, decision-making, and precision medicine in inflammatory bowel disease (IBD). In particular, AI could improve precision medicine for IBD by enabling identification of disease subtypes, prediction of disease progression and treatment response, selection of personalized treatments, and remote monitoring. Predictive models can benefit clinicians and patients alike by optimizing shared decision-making processes; patients can also use AI to cope with daily and long-term challenges of the disease. Beyond patients and practitioners, predictive models may positively impact healthcare structures and payers by enabling effective healthcare-resource utilization. To increase the accuracy and efficiency of AI models, biomarkers, patient-reported outcomes, and disease scores should be combined within predictive models, and the outputs should be compared with clinical trial data and real-world data for validation. [ABSTRACT FROM AUTHOR]

This paper describes the current situation of the provision of speech-language services in East Africa. An overview of the educational opportunities, workforce density, communication rehabilitation planning, caseload, and ethical and/or cultural challenges is provided. A narrative review was performed. All papers referring to communication disorders in East African countries were identified from EMBASE, PubMed, ISI Web of Science: Science Citation Index Expanded, and ISI Web of Science: Conference Proceedings Citation Index-Science using the following search terms: speech therapy, speech pathology, speech-language pathology, speech-language rehabilitation, speech-language therapy, logopedics, East Africa, communication disorders, communication difficulties. Two concepts were combined with a Boolean operator 'AND'. At present, there is an alarming shortage of speech-language pathologists in East Africa. This issue is mainly related to the limited availability of educational programs in speech-language pathology. Although more and more universities are beginning to offer such educational programs, the number of available speech-language pathologists is still too low to meet the needs of all children with communication disorders. In addition, speech-language pathologists are often faced with different cultural and ethical obstacles when they provide intervention to East African children with communication disorders. These speech-language pathologists are therefore challenged to take a broader view of their role as a therapist. These alternative roles often include training of other individuals in the context of community-based rehabilitation. In the future, it will be important to carefully consider the development of sustainable learning opportunities in East African contexts. Initiatives, for example, "train-the-trainer" workshops, are needed to support the speechlanguage pathologists. Existing models like the communication disability model can aid to create holistic frameworks for the development of sustainable speech-language services in the East African countries. [ABSTRACT FROM AUTHOR]

Communication is central to the accomplishment of each of the United Nations' 17 Sustainable Development Goals (SDGs) and is a fundamental human right. This special issue of the International Journal of Speech-Language Pathology (IJSLP, vol. 25, no. 1) is dedicated to communication, swallowing and the SDGs; particularly focussing on people with communication and/or swallowing disability and those who support them. The papers in the special issue of IJSLP demonstrate that successful communication is necessary for realisation of all 17 SDGs at both a global and an individual level and advance the international call for SDG 18: Communication for All. The 36 papers address all 17 goals, focussing on poverty, hunger, health, education, work, innovation, climate, cities, land, oceans, justice, and partnerships. Authors worked and undertook their research in Australia, Austria, Benin, Cambodia, Cameroon, Canada, China, Columbia, Denmark, Egypt, Ethiopia, Ghana, Greece, Iceland, India, Iraq, Ireland, Italy, Jordan, Kenya, Lebanon, Maldives, Mozambique, Nepal, New Zealand, Nigeria, State of Palestine, Peru, Philippines, Rwanda, Serbia, South Africa, Uganda, UK, USA, Vietnam. Communication for all is essential for the achievement of the SDGs, "peace and prosperity for people and the planet" (United Nations, 2015a). Achievement of the SDGs is the role of all; including communication specialists, people with communication/swallowing disability, their families and communities. [ABSTRACT FROM AUTHOR]

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Participation in society is the cornerstone to living a meaningful, connected, and healthy life. Persons with complex communication needs, however, often have restricted opportunities to participate in everyday contexts and situations. Reasons for this include societal attitudinal barriers, as well as limited knowledge and skills about augmentative and alternative communication (AAC) to enhance participation. Enhancing participation of persons with complex communication needs requires a holistic and multi-faceted approach. The 17 Sustainable Development Goals (SDGs) with their disability-inclusive agenda provide an impetus for shaping the approach of the Centre for Augmentative and Alternative Communication (CAAC) in enhancing participation of persons with complex communication needs in South Africa. This paper aims to provide a reflective description and application of the work conducted by the CAAC in addressing the SDGs in South Africa. Research and training conducted by the CAAC is shown to be aligned to five SDGs, namely zero hunger (SDG 2), good health and well-being (SDG 3), quality education (SDG 4), decent work and economic growth (SDG 8) and peace, justice, and strong institutions (SDG 16), with a focus on reaching these goals in order to benefit persons with complex communication needs. The paper demonstrates that, despite some gains in addressing the SDGs, research and clinical practice still needs to be on these and the remaining SDGs. Furthermore, there is a need to also find ways to integrate the SDGs to ensure participation of persons with complex communication needs in major life activities and society. [ABSTRACT FROM AUTHOR]

The United Nations' Sustainable Development Goals and the UNICEF/WHO Nurturing Care Framework for supporting children's health and development present unique international opportunities for speech-language pathologists to contribute support to early childhood development and Sustainable Development Goals (especially SDG 4 and SDG 17) in diverse international contexts. The crucial role that parent/caregiver support plays in promoting Nurturing Care and sustainable education is often underappreciated, so the objective of this paper is to describe key concepts and importance of parent/caregiver support in the Nurturing Care Framework and the SDGs. This commentary focusses on SDG 4, which is foundational to individuals, communities and societies in creating an education framework that includes and harnesses family and community support. This paper also includes as an example a comprehensive program that has been developed and implemented in the People's Republic of China that includes speech and language skills as an explicit component. The results in China indicate that a program of universal developmental facilitators can be implemented within an educational and paediatrician/developmental paediatrician centred health care context. Sustainable Development Goal 4 and UNICEF/WHO Nurturing Care Framework are important and innovative programs that explicitly harness parent education and training to identify and address the needs of children with developmental difficulties utilising paediatricians, speech language pathologists, allied health personnel, teachers, and community stakeholders proactively for implementation. The program's adoption and success in the China suggest that it provides a model which can be adapted internationally within the context of national health programs. [ABSTRACT FROM AUTHOR]

More than 700 million people globally are still living in extreme poverty. No poverty (Sustainable Development Goal 1, SDG 1), is considered to be the greatest global challenge. This paper aims to outline the effects of poverty on communication and swallowing disabilities across the lifespan and steps to take for its amelioration. Poverty and disability are in a vicious cycle with each being a cause for and a consequence of the other. Poverty has incontrovertible and significant ramifications for communication and swallowing disabilities across the lifetime from pregnancy to old age. The individual, family and social burden and costs of these disabilities have lifelong economic and social consequences. Considering poverty is a known and important determinant of communication and swallowing disabilities, the most potent weapon is to focus on preventing and ameliorating poverty-related communication and swallowing disabilities in children. A call to action is issued to speech-language pathologists to take steps towards this goal. This commentary paper focusses on Sustainable Development Goal of no poverty (SDG 1) and also addresses zero hunger (SDG 2), reduced inequalities (SDG 10), and climate action (SDG 13). [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodResultConclusionEthiopia is the second most populous country in sub-Saharan Africa. While Ethiopia’s health care system includes primary health centres, general, and specialised hospitals, allied health care like speech-language pathology was not available until 2003. This article was written with the aim of sharing the experience of establishing speech-language pathology as a profession and the first speech-language pathology training program in Ethiopia.In this paper, we retrospectively examine how the leadership of local stakeholders, a multidisciplinary team, and the development of a professional infrastructure led to the success of the program. The authorship group, who were involved in the program from inception to implementation, share their experiences.The speech-language pathology undergraduate program at Addis Ababa University graduated its first class in 2019. Plans to grow the training program at the graduate level are ongoing.This novel program, grown from several international partnerships, is an example of how low- and middle-income countries can improve access to the service providers necessary to treat their populations. [ABSTRACT FROM AUTHOR]

Facilitated communication (FC) has been a heavily debated and documented topic across multiple disciplines, including sociology, education, psychology, pediatrics, speech-language pathology, and disability studies. Although many professionals from various disciplines and advocates have offered opinions, suggestions, and research on the topic, there has been minimal input from the occupational therapy (OT) profession. The lack of OT input is noteworthy as OTs are experts in enabling upper extremity performance and independence through a variety of training, adaptation and modification strategies, and use of external supports. Because of their professional code of ethics and a specific knowledge base, OTs are uniquely positioned to provide a host of ethical and evidence-based strategies that enable independent access to communication technology. The consideration of multiple access options is contrary to the typical facilitated encounter where facilitators exclusively choose to manipulate an upper extremity in order for letters to be selected on a display or keyboard. The purpose of this paper is threefold: (a) To offer insight into the standard of care by OTs including their ethical standards; (b) to identify varied accommodations that enable access using a feature-matching standard of care that eliminates the need for a facilitator; and (c) to highlight how to increase independent assistive technology/augmentative and alternative communication access, thus dissuading the need or use of facilitated access to letters. [ABSTRACT FROM AUTHOR]

Background : Clinicians face significant obstacles in their access to evidence for the efficacy of different communicative and cognitive treatments after brain impairment. These include the need to search across diverse journals and different clinical conditions to find potential treatments and the lack of easily accessible standards by which to evaluate the methodological rigour of treatment studies once found. Aims : We aimed to address these issues by developing a freely available, user‐friendly database of all relevant treatment trials for psychologically based disorders that arise from brain impairment. Methods & Procedures : PsycBITE TM (http:// www.psycbite.com ) was developed as an internet‐based database and was officially launched in 2004. Included on PsycBITE TM are all trials that have been published that evaluate treatment for any communication, cognitive, or psychological disorder arising from any form of acquired brain impairment in children (above the age of 5 years) and adults. PsycBITE TM also provides a rating for the methodological rigour of each trial using the previously established PEDro scale (Maher, Sherrington, Herbert, Moseley, & Elkins, 2003) for randomised controlled trials (RCT) and non‐RCT group comparisons. A PsycBITE TM rating scale for single case experimental studies is still under development. This report overviews the database, its contents, and the methodology by which papers are selected for inclusion. Outcomes & Results : As of June 2005 there are 1167 treatment studies listed on PsycBITE TM with prospective searches being conducted on a regular basis. The highest proportion of studies report treatments for communication disorders followed by behavioural problems and memory. Ratings of the randomised controlled trials, group comparisons, and single case studies are available for a proportion of papers and are being updated continuously. Conclusions : PsycBITE TM is an invaluable resource for clinicians and researchers interested in an evidence‐based practice approach to treatment. It is a free, fast, and effective way of accessing and evaluating treatments for communicative and cognitive disorders following brain impairment. [ABSTRACT FROM AUTHOR]

Natural disasters can significantly impact children's health, development, and wellbeing, as well as their access to education and support services (including speech-language pathology). Children's needs are often overlooked in the urgent aftermath of natural disasters. This is especially true for children with communication difficulties. This commentary explores the impacts of bushfire on Australian children, to propose a sustainable, community-based approach to supporting children's health, wellbeing, and communication. The Royal Far West Bushfire Recovery Program, a multidisciplinary allied health program, supported children's recovery, resilience, and development in the aftermath of Australia's Black Summer bushfires in 2019–2020. Children learnt coping strategies and were more able to communicate with adults and peers about their feelings and experiences, but residual impacts of bushfires remained for some children. Allied health telepractice services, including speech-language pathology, enhanced access for vulnerable children, highlighting the potential for technology to provide high-quality services to support recovery, particularly in remote areas. Climate change increases the frequency and severity of bushfires and other natural disasters with significant consequences for vulnerable and at-risk communities. Children with communication needs are particularly vulnerable during and following these disasters. High quality, evidence-based interventions are needed to support the health, wellbeing, and communication needs of children, with opportunities for involvement of speech-language pathologists. This commentary paper focusses on SDG 1, SDG 3, SDG 4, SDG 9, SDG 10, SDG 11, SDG 13, and SDG 15. [ABSTRACT FROM AUTHOR]

To stimulate critical thought, to challenge how speech-language pathologists (SLPs) achieve Sustainable Development Goals (SDGs) in supporting people with swallowing/communication disabilities, using a critical, political conscientisation approach. We generate data from our professional and personal experiences interpreted through a decolonial lens to demonstrate how Eurocentric attitudes and practices are at the core of SLPs' knowledge base. We highlight risks associated with SLPs' uncritical use of human rights, the bases of the SDGs. While SDGs are useful, SLPs should take the first steps of becoming politically conscientised to consider whiteness, to ensure that deimperialisation and decolonisation are tightly woven into our sustainable development work. This commentary paper focusses on the SDGs a whole. [ABSTRACT FROM AUTHOR]

To showcase how applications of automatic speech recognition (ASR) technology could help solve challenges in speech-language pathology practice with children with communication disability, and contribute to the realisation of the Sustainable Development Goals (SDGs). ASR technologies have been developed to address the need for equitable, efficient, and accurate assessment and diagnosis of communication disability in children by automating the transcription and analysis of speech and language samples and supporting dual-language assessment of bilingual children. ASR tools can automate the measurement of and help optimise intervention fidelity. ASR tools can also be used by children to engage in independent speech production practice without relying on feedback from speech-language pathologists (SLPs), thus bridging the long-standing gap between recommended and received intervention intensity. These innovative technologies and tools have been generated from interdisciplinary partnerships between SLPs, engineers, data scientists, and linguists. To advance equitable, efficient, and effective speech-language pathology services for children with communication disability, SLPs would benefit from integrating ASR solutions into their clinical practice. Ongoing interdisciplinary research is needed to further advance ASR technologies to optimise children's outcomes. This commentary paper focusses on industry, innovation and infrastructure (SDG 9) and partnerships for the goals (SDG 17). It also addresses SDG 1, SDG 3, SDG 4, SDG 8, SDG 10, SDG 11, and SDG 16. [ABSTRACT FROM AUTHOR]

Equitable partnerships across borders, sectors and communities are integral in creating shared understanding, novel solutions and sustainable development. Sustainable development goal (SDG) 17: Partnerships for goals, focuses on strengthening global partnerships. This highlights the importance of partnership as a tool to support the achievement of all SDGs. Partnerships are particularly vital to creating sustainable and appropriate services to support people who experience communication or swallowing disability and their families, in under-served communities, where services and expert personnel may be limited and where innovative strategies are required for working with families and communities to improve service accessibility. To reflect on key principles underpinning the creation of a speech–language pathologists' (SLPs') community of practice, designed to support SLPs from high-, low- and middle-income countries to develop equitable partnerships, aimed at supporting people who experience communication or swallowing disability their families. We draw on the authors' experiences of building partnerships to enhance participation for people who experience communication or swallowing disability. We discuss the need for global partnerships and challenges with current funding mechanisms. We use the principles of the speech–language pathology community of practice and concepts from the Partnership Accelerator 2030 Agenda to frame reflections and recommendations. This commentary paper focuses on partnerships for the goals (SDG 17). [ABSTRACT FROM AUTHOR]

Minority World countries have often been involved in supporting services for people with communication disability (PWCD) in Majority World countries. In East Africa, this support has historically involved speech-language pathologists (SLPs) from Minority World countries providing therapy; later evolving to include partnerships between Majority and Minority World organisations providing education, training, and support—sometimes with the aim of increasing service sustainability. Our objective is to provide an overview of how partnerships for the goals (SDG 17) has been realised for speech-language pathology services in three East African countries (Uganda, Kenya, and Rwanda). For SLPs, we consider training and education, research opportunities, and the development of the profession. For PWCD, we consider the equity of services. We identify key challenges and successes of UK/East African partnerships, identifying steps for improvement for robust speech-language pathology partnerships. We suggest three key approaches for better-designed partnerships: (1) Improve accessibility, by expanding services to rural areas and coordinating fee setting. (2) Ensure local stakeholders and professionals are included in meaningful and agreed ways. (3) Ensure partnerships complement existing services and are culturally appropriate. These approaches support related goals to achieve better services for PWCD. This commentary paper focuses on good health and well-being (SDG 3); quality education (SDG 4); decent work and economic growth (SDG 8); industry, innovation, and infrastructure (SDG 9); reduced inequalities (SDG 10); partnerships for the goals (SDG 17). [ABSTRACT FROM AUTHOR]

The right to communicate, by any means, is key to participation in peaceful and just societies. Participation relies on societal equality which, in turn, depends upon consensus that everyone has the same rights, as well as responsibility to uphold the rights of all. People who experience communication disability are, however, often invisible, misunderstood, stigmatised, and under-enumerated, particularly in resource-limited settings, including humanitarian contexts. A lack of identification and understanding of needs exclude this group from equal societal participation and exposes them to risks, including sexual and gender-based violence (SGBV), which has no place in a peaceful, just, and fair society. In this commentary we explore the importance of the full inclusion and participation of people who experience communication disability, to the fulfilment of Sustainable Development Goal (SDG) 16. There is a lack of specialist assistance for people who experience communication disability in resource-limited and humanitarian contexts. A broader approach to community and service-provider capacity-building on communication disability demonstrates potential to build stronger institutions and increase societal inclusion and participation, thereby reducing exposure to risks, such as SGBV. Such approaches include increasing public understanding and use of accessible communication strategies, as well as addressing negative attitudes/behaviours and fear. Speech-language pathologists (SLPs) must be prepared to expand their spheres of influence and develop long-term relationships with stakeholders who can instigate change. This may involve de-emphasising our SLP credentials, instead rebranding ourselves as inclusion specialists, with a focus on communication disability. Increased inclusion, participation, and protection are achievable for people who experience communication disability if they are understood, counted, and served appropriately. This requires alignment of communication rights agendas with international development priorities. As such, this commentary paper focuses on peace, justice, and strong institutions (SDG16) and simultaneously addresses aspects of good health and wellbeing (SDG 3), gender equality (SDG 5), reduced inequalities (SDG 10), and partnerships for the goals (SDG 17). [ABSTRACT FROM AUTHOR]

Sepsis is a major global health problem with an estimated 49 million cases globally each year causing as many as 11 million deaths. The primary objective of this commentary is to describe the impacts of sepsis and critical illness on communication and swallowing function, and to discuss management strategies considering the Sustainable Development Goals (SDGs). Communication and swallowing disabilities can occur with sepsis and critical illness. A holistic framework to optimise function, recovery, and future research priorities across the lifespan can be developed through the SDGs. Communication and swallowing disabilities following critical illness associated with sepsis have global impacts. Early multidisciplinary engagement is key to optimising individuals' function. Collaborative research, education, and public awareness is urgently needed to increase equity in health outcomes across populations. This commentary paper supports progress towards good health and well-being (SDG 3), quality education (SDG 4) and reduced inequalities (SDG 10). [ABSTRACT FROM AUTHOR]

Copy number variants (CNVs) found in individuals with communication deficits provide a valuable window to the genetic causes of problems with language and, more generally, to the genetic foundation of the human-specific ability to learn and use languages. This paper reports on the language and communication problems of a patient with a microduplication in 22q11.23 and a microdeletion in 7q31.1-q1.33 encompassing FOXP2. The proband exhibits severe speech problems and moderate comprehension deficits, whereas her pragmatic abilities are a relative strength, as she uses gestures quite competently to compensate for her expressive issues. This profile is compatible with the deficiencies found in patients with similar CNVs, particularly with people bearing microdeletions in 7q31.1-q31.33. [ABSTRACT FROM AUTHOR]

Children and youth with severe motor and communication impairment (SMCI) have difficulty providing self-expression through typical speech, writing with a paper and pencil, or using a standard keyboard. Their emotional expressions can be missed by peers and novel caregivers. To describe the indicators and components of emotional experiences for children/youth with SMCI. Primary guardians of nine children/youth with SMCI were involved in photo/video data collection and follow-up qualitative interviews. Twenty-one familiar people (e.g., friends, family members, and/or care team) participated in semi-structured qualitative interviews. A conceptual understanding of emotional well-being specific to the population has been developed consisting of nine themes, encompassed by four domains i) Core Attributes, ii) Personal Experiences, iii) Surroundings, iv) Expression and Reception. Emotional experiences of children/youth with SMCI are diversely expressed. Primary guardian and familiar person insight can be amplified to positively impact care and participation. [ABSTRACT FROM AUTHOR]

Assessing the impact of dysarthria on a patient's ability to communicate should be an integral part of patient management. However, due to the high demands on reliable quantification of communication limitations, hardly any formal clinical tests with approved psychometric properties have been developed so far. This study investigates a web-based assessment of communication impairment in dysarthria, named KommPaS. The test comprises measures of intelligibility, naturalness, perceived listener effort and communication efficiency, as well as a total score that integrates these parameters. The approach is characterized by a quasi-random access to a large inventory of test materials and to a large group of naïve listeners, recruited via crowdsourcing. As part of a larger research program to establish the clinical applicability of this new approach, the present paper focuses on two psychometric issues, namely specificity and sensitivity (study 1) and retest-reliability (study 2). Study 1: KommPaS was administered to 54 healthy adults and 100 adult persons with dysarthria (PWD). Non-parametric criterion-based norms (specificity: 0.95) were used to derive a standard metric for each of the four component variables, and corresponding sensitivity values for the presence of dysarthria were identified. Overall classification accuracy of the total score was determined using a ROC analysis. The resulting cutscores showed a high accuracy in the separation of PWD from healthy speakers for the naturalness and the total score. Study 2: A sub-group of 20 PWD enrolled in study 1 were administered a second KommPaS examination. ICC analyses revealed good to excellent retest reliabilities for all parameters. [ABSTRACT FROM AUTHOR]

The prevalence of autism spectrum disorders (ASD) is increasing, and the correlates of involvement of this population in the criminal justice system have been reported. People with ASD have specific deficits such as difficulties in social communication and behavior, impulsivity, misinterpretation of rules, obsessions, and restricted interests, increasing their vulnerability to becoming victims and offenders. Herein, we report the case of a male 40 high-functioning ASD patient accused of stalking. This paper highlights clinical and forensic challenges when assessing patients with ASD prosecuted for stalking behaviors. [ABSTRACT FROM AUTHOR]

Purpose: Qualitative research methods, grounded in an inductive analytic paradigm, increasingly inform clinical practice in the field of speech-language pathology. Social media research, often including qualitative methods, provides a valuable way to connect and listen to the voices of people with communication disabilities. With growing empirical evidence on the ways that people with communication disabilities use social media, and recognition of both benefits and limitations of its use, it is important to consider what will support clinicians to translate this work conceptually and safely into clinical practice. Method: In this paper, we use the tools of metaphor and arts-based knowledge translation to promote the translation of evidence into social media practice. Results: With social media being an important ecosystem to grow and nurture in speech-language pathology, a "picturing a social media garden" metaphor is proposed to further research translation. The metaphor will be used to frame strategies for applying qualitative techniques for speech-language pathologists to consider how to use social media in clinical and professional practice, as well as citing supporting literature to guide further reading. Conclusion: The suggested approaches could augment existing methods of assessment and intervention for people with communication disabilities and provide support for clinicians who want to develop their own strategy for using social media, build a vibrant social media ecosystem, and integrate social media interventions into their clinical services. [ABSTRACT FROM AUTHOR]

Explore methods used in peer-reviewed literature for obtaining self-expression of well-being information from children with severe motor and communication impairment (SMCI). A comprehensive search was conducted on 22 August 2019 through academic databases: CINAHL; Embase; MEDLINE; PsycINFO; InSpec; Compendex. Search strategies were informed by keywords under the following areas: (1) population: children with SMCI, (2) assessment methods: alternative to natural speech, paper and pencil report or standardized keyboard use (e.g., eye gaze) and (3) target information: well-being (e.g., quality of life). Studies were excluded if they focused on individuals over 25-years old, exclusively autism or typically developing children. Non-duplicate studies of 10,986 were screened; 49 studies met inclusion criteria. Most studies used high-tech methods of self-expression in a single context (n = 17). Familiar partners play a significant role in self-expression; 18 studies required a familiar partner for children with SMCI to self-express. Thirty-five studies involved children self-expressing to solely adults, in comparison to 14 studies which involved peers. Findings highlight the advancement of high-tech communication devices restricted to application in single contexts. Familiar partner knowledge of children with SMCI has the potential to be shared with others (e.g., respite care providers), enhancing both caregiver and child well-being. Future research that would enhance the literature could explore the assessment of emotional well-being for application in various contexts using multimodal methods. Opportunities for children with SMCI to express their emotional well-being can further influence the understanding and enhancement of participation, social connections, and experiences. Use of lower tech methods of self-expression to obtain information directly from children with severe motor and communication impairment (SMCI) remain more feasible in home and school contexts. By utilizing familiar partners' experiences and knowledge of the child, respite care providers, novel support workers, and others involved in the lives of children with SMCI can become further informed. Current high-tech methods for obtaining the emotional expressions of children with SMCI may benefit from incorporating multimodal approaches including lower tech methods, to be feasibly applied in real world contexts where well-being takes place. Further research on this topic is imperative to enable children with SMCI to self-express their emotional well-being which can enhance participation, activities, social connections, and experiences. [ABSTRACT FROM AUTHOR]

Single-Case Experimental Designs (SCEDs) have lately been recognized as a valuable alternative to large-group studies. SCEDs form a great tool for the evaluation of treatment effectiveness in heterogeneous and low-incidence conditions, which are common in the field of communication disorders. Mediation analysis is indispensable in treatment research because it informs researchers about the mechanism through which the intervention leads to changes (e.g., communication skills) in the outcome of interest (e.g., developmental outcomes). Despite the increasing popularity of both SCEDs and mediation analysis, there are currently no methods for estimating mediated effects for a single individual. This paper describes how Bayesian piecewise regression analysis can be used for mediation analysis in SCEDs. A Playskin LiftTM dataset from one infant born preterm who is at risk for cognitive developmental delays is used to illustrate two approaches to mediation analysis in SCEDs: Bayesian computation of the mediated effect and Bayesian informative hypothesis testing. Annotated R code is provided so researchers can easily fit the proposed models to their own SCED data set. Advantages and limitations of the method are discussed. [ABSTRACT FROM AUTHOR]

This paper addresses the leader-following consensus problem of networked Lagrangian systems with unknown control directions and uncertain dynamics. For undirected graphs and directed graphs, two types of distributed control protocols are proposed without assuming that the leader's position information is linearly parameterised. It is proven that all signals in the closed-loop system are bounded, and a leader-following consensus can be achieved with the proposed corresponding protocols. These protocols are distributed in the sense that the control input for each Lagrangian system is solely based on local relative position and velocity information from its neighbourhood set and does not require additional information, e.g. acceleration or observer information of its neighbours, thus avoiding the dead-loop problem and reducing the communication burden. Simulations on networked two-link revolute joint arms are given to validate the theoretical findings. [ABSTRACT FROM AUTHOR]

Purpose: Communication changes in multiple sclerosis (MS) are under-explored and under-recognised. Persons with MS (PwMS) are experts in their condition and play a valuable role in informing clinicians and researchers of their condition. This study aimed to investigate the perspectives of PwMS on: (1) MS-related communication changes, (2) the impact of these communication changes across key aspects of a person's life, including work/studies, relationships, and general quality of life, and (3) strategies used to facilitate communication in daily interactions. Method: Two-hundred and sixty PwMS were recruited internationally and completed an online questionnaire. Content analysis was used to analyse open-ended questionnaire responses. Result: One-hundred and ninety-seven (75.8%) participants reported communication changes, including language, cognitive, speech, voice, and fluency changes. Participants described a variety of personal and environmental factors that influence communication negatively, such as fatigue, stress, and heat. Communication changes were reported to impact on psychological wellbeing, interpersonal relationships, participation and identity in the workforce and career pathways, and tertiary studies. Around 40% of participants reported using a range of overt and covert strategies to manage communication changes. Only 11.2% (n = 22/197) of participants who reported communication changes accessed speech-language pathology (SLP) services. Conclusion: PwMS can experience a wide spectrum of communication changes. These communication changes can have a profound and far-reaching impact on psychological wellbeing and societal participation. Engagement with SLP services is limited compared to the reported prevalence of communication changes. There is a need to raise awareness of the role of SLP in service provision for PwMS to manage communication changes. This paper discusses and provides suggestions for SLP services for PwMS with communication changes. There is a timely need to develop evidence-based interventions to support PwMS manage communication changes and reduce their impact. [ABSTRACT FROM AUTHOR]

Attention and communication difficulties are common yet often invisible following Traumatic Brain Injury (TBI). The focus of this paper is to use practice-based evidence from health professionals working with individuals following TBI to gain a deep and relevant understanding of the impact that attention and communication can have in the lives of individuals following TBI. This dataset comes from a larger mixed-methods study that includes a survey with both open and closed questions and focus group data sources. Thematic analysis was completed on a single open-ended question from the survey of health professionals. It asked health professionals about the outcomes they believe are directly related to attention difficulties that result in specific communication difficulties. Responses from 73 health professionals who work in neurorehabilitation generated five themes: behavior, connections, self, purpose, and empowerment. The themes were pervasive across all aspects of the recovery journey for individuals post-TBI The implications for clinical practice and future research indicate a need to focus on attention-related strategies for language deficits; treating communication difficulties related to relationships and friendships; and redefining a sense of self following TBI. [ABSTRACT FROM AUTHOR]

Corpora of speech of individuals with communication disorders (CSD) are invaluable resources for education and research, but they are costly and hard to build and difficult to share for various reasons. DELAD, which means 'shared' in Swedish, is a project initiated by Professors Nicole Müller and Martin Ball in 2015 that aims to address this issue by establishing a platform for researchers to share datasets of speech disorders with interested audiences. To date four workshops have been held, where selected participants, covering various expertise including researchers in clinical phonetics and linguistics, speech and language therapy, infrastructure specialists, and ethics and legal specialists, participated to discuss relevant issues in setting up such an archive. Positive and steady progress has been made since 2015, including refurbishing the DELAD website () with information and application forms for researchers to join and share their datasets and linking with the CLARIN K-Centre for Atypical Communication Expertise () where CSD can be hosted and accessed through the CLARIN B-Centres, The Language Archive () and TalkBank (). The latest workshop, which was funded by CLARIN (Common Language Resources and Technology Infrastructure) was held as an online event in January 2021 on topics including Data Protection Impact Assessments, reviewing changes in ethics perspectives in academia on sharing CSD, and voice conversion as a mean to pseudonomise speech. This paper reports the latest progress of DELAD and discusses the directions for further advance of the initiative, with information on how researchers can contribute to the repository. [ABSTRACT FROM AUTHOR]

Speech-language pathologists play important roles in supporting people to be competent communicators in the languages of their communities. However, with over 7000 languages spoken throughout the world and the majority of the global population being multilingual, there is often a mismatch between the languages spoken by children and families and their speech-language pathologists. This paper provides insights into service provision for multilingual children within an English-dominant country by viewing Australia's multilingual population as a microcosm of ethnolinguistic minorities. Recent population studies of Australian pre-school children show that their most common languages other than English are: Arabic, Cantonese, Vietnamese, Italian, Mandarin, Spanish, and Greek. Although 20.2% of services by Speech Pathology Australia members are offered in languages other than English, there is a mismatch between the language of the services and the languages of children within similar geographical communities. Australian speech-language pathologists typically use informal or English-based assessments and intervention tools with multilingual children. Thus, there is a need for accessible culturally and linguistically appropriate resources for working with multilingual children. Recent international collaborations have resulted in practical strategies to support speech-language pathologists during assessment, intervention, and collaboration with families, communities, and other professionals. The International Expert Panel on Multilingual Children's Speech was assembled to prepare a position paper to address issues faced by speech-language pathologists when working with multilingual populations. The Multilingual Children's Speech website () addresses one of the aims of the position paper by providing free resources and information for speech-language pathologists about more than 45 languages. These international collaborations have been framed around the World Health Organization's International Classification of Functioning, Disability and Health (ICF-CY) and have been established with the goal of supporting multilingual children to participate in society. [ABSTRACT FROM AUTHOR]

Locating the best available research, critically appraising it and synthesizing the findings with evidence from practice and the wishes of the service user and/or their advocate(s) is central to providing high-quality services to people with communication impairments. Determining whether research evidence is high quality, recent, and relevant is a particular challenge for practitioners. Knowledge translation strategies such as providing critical appraisals of research and advice on how to apply the findings provide useful support to the decision-making process. There are a number of formats that provide critical appraisals of research, the most familiar being systematic reviews, critically appraised papers, and rapid reviews. A critically appraised topic (CAT) is one form of rapid review that can be particularly useful for informing practice in a rich and nuanced manner. We will discuss the features of CATs along with similarities and differences to systematic reviews, critically appraised papers, and other types of rapid reviews. Additionally, we will provide guidance on how to conduct a CAT, present the information, and use it to support high-quality communication assessment and intervention practice. [ABSTRACT FROM AUTHOR]

Purpose: Social communication deficits are a severely debilitating aspect of traumatic brain injury (TBI), and there is strong clinical and research interest in how social communication interventions work for this population. Informed by a companion paper targeting assessment of social communication impairments post-TBI, this paper reviews relevant treatment theories and provides an inventory of social communication treatment components. Method: We completed a mapping review examining 17 articles from recent literature reviews and 4 updated articles from a literature search to identify treatment targets and ingredients using the Rehabilitation Treatment Specification System (RTSS). Result: Social communication interventions are primarily based on behavioural and cognitive treatment theories. Common social communication treatment targets include changing skilled behaviours and cognitive or affective representations. We offer a menu of therapeutic ingredients and treatment considerations which represent the current state of social communication interventions. Conclusion: By reviewing the social communication intervention literature through a theoretical lens, we identify which treatment targets are missing, which targets are being addressed, and which therapeutic ingredients (i.e. clinician activities) are recommended. A hypothetical case study is provided as a supplement to demonstrate how speech-language pathologists may integrate treatment theory, ingredients, and targets into clinical practice. [ABSTRACT FROM AUTHOR]

A critically appraised topic (CAT) is one form of rapid review that can be particularly useful for informing practice. The purpose of this CAT was to determine what caregivers of preschool-aged children with speech, language or communication disorders (2–5 years of age) think of their involvement in speech-language pathology intervention in community-based settings. In addition to this CAT, the authors present and discuss a methodology for qualitative critically appraised topics (this issue). The authors propose an update to this CAT in June 2021. [ABSTRACT FROM AUTHOR]

Since Freud, psychoanalytic case studies have been scrutinised as irredeemably subjective anecdotal reports. This paper explores criticisms at three different levels: suggestive influence and scientific judgment (case study as a form of classification and judgment); (counter)transference as a 'problem child' (case narrative as an emotionally biased communication); validation (case study as an anecdotal report with non–generalisable findings). In exploring these different criticisms, the paper also investigates different historical reactions toward the genre of psychoanalytic case study and the practice of case writing, as well as the significance of research pragmatism for psychoanalytic research in particular and psychological research more broadly. By bringing these criticisms and responses together, the paper seeks to provide a snapshot of how case studies survived the sceptics, and what past lessons can be learnt in developing the case study method further. [ABSTRACT FROM AUTHOR]

Modern speech-language pathology practices (SLPPs) have adopted tablet games in recent years. Research is needed to take advantage of the potential benefits tablets can offer and to explore the factors that influence its introduction. This paper discusses a survey that was conducted to investigate the factors that influence speech-language pathologists’ (SLPs) beliefs and the actual use of tablets in SLPPs. The results of the survey, conducted among Slovenian SLPs, indicated that their most positive beliefs concerning tablets relate to social influence. Specifically, the beliefs relate to children’s interest and practice with tablets and have a significant impact on the decision-making of SLPs concerning introducing tablets in therapy. Conversely, SLPs’ most negative beliefs relate to the conditions for facilitating tablet use, particularly the lack of Slovenian applications. This paper discusses a separate case study that was conducted in which tablet game-supported therapy was introduced to a group of 44 children. The case study results indicated that the children accepted the use of tablet games for therapy purposes and the games had a positive impact on the children’s motivation and satisfaction. [ABSTRACT FROM AUTHOR]

Purpose:In 2013, the Australian Government Senate formed a committee for inquiry and report into the prevalence of speech, language, and communication disorders and speech pathology services in Australia. Submissions were sought from individuals and organisations. In this paper, submissions made by individuals with a history of childhood communication disorder were examined to explore their life experiences and the impact on their lives when the right to communicate could not be enacted. Method:There were 305 submissions to the Australian Government Senate Committee Inquiry, of which 288 were publically accessible. In this study, the submissions (n = 17) from children or adults with a history of communication disorder (including speech, language and stuttering), who provided personal accounts of their experiences, were analysed using an interpretative phenomenological approach. Result:Four themes emerged relating to: personal identity, life with communication disorder, the importance of help, and how life would be different without a communication disorder. Conclusions:This paper gives voice to children and adults with communication disorder. In listening to these voices, the impact of communication disorder on the right to communicate and on other human rights can be heard, and the need for a response is clear. However, the challenge is to determine how the voices of these individuals, and others like them, can be enabled to exert real influence on practice and policy so communication disorder will no longer be a barrier to attainment of their human rights. [ABSTRACT FROM PUBLISHER]

Developed with a strong awareness of past injustices, South Africa’s progressive constitution emphasises a full spectrum of human rights. While the constitution celebrates many languages and cultures, speech-language pathologists (SLPs) face challenges in translating these values into practice with a diverse clientele. Similarly, Article 19 of the Universal Declaration of Human Rights focuses on freedom of expression in one’s language of choice, but is often perceived as a “Cinderella” right (i.e. one that is frequently neglected). This paper presents a literature review undertaken in association with the Health Professions Council of South Africa to produce guidelines to support SLPs in their practice with diverse linguistic and cultural groups. The aim was to identify key points for inclusion in a set of human rights-driven guidelines. Specific objectives were to critique: (1) current guidelines for SLPs working with diverse cultural and linguistic groups; and (2) equivalent guidelines for related professions. Content analysis of the datasets revealed key themes which formed the basis of an initial skeleton, to be further developed through a consultative process and discussion, ultimately aiming to provide supportive, practical guidelines to better equip South African SLPs to serve all the people of the country. [ABSTRACT FROM PUBLISHER]

Although the literature suggests that multilingual augmentative and alternative communication (AAC) interventions hold benefits for children from multilingual backgrounds, there is little guidance on how such interventions can be implemented. While various barriers to this process have been noted, language ideology has not received much attention in the AAC literature. This paper aims to highlight multilingualism as both a linguistic and a sociopolitical phenomenon. An awareness of the influence of language ideology on AAC practice may lead to more considered and reflective approaches when supporting multilingual clients and their families. A description of the multilingual experience is followed by a discussion of language ideologies and views of multilingualism and how these may translate into AAC practices. Through a series of questions, AAC practitioners are encouraged to reflect on the influence of language ideology on their practices. The influence of language ideology on the legal and policy context, service models, and family language practices and choices is then explored. By situating AAC interventions for children from multilingual backgrounds within a macrosystemic and ideological framework, researchers and practitioners may be able to identify not just constraints on but also opportunities for providing person- and family-centered intervention. [ABSTRACT FROM AUTHOR]

The purpose of this article is to explore the Sustainable Development Goal of reduced inequalities (SDG 10) in relation to the experiences of people with communication disability with lived experiences and their access to self-determined healthcare. As such, the article also informs the goal of good health and well-being (SDG 3). In preparing this article the authors reviewed recent literature on digital health records and digital autonomy as a means to improving equity of access and explored the experiences of two of the authors as people with severe communication disability who use a wide range of digital health technologies in pursuing safe and quality health care. The literature and their experiences highlight a need for improved co-design and usage across disability and health service systems management if e-health records are to be used to reduce inequalities in accessing healthcare. Recent research and the lived experiences of the first two authors reflect that e-health information systems, designed to improve the consumer's ability to access and share their own health information, are not used to full advantage in disability and healthcare environments. Increased access to multimodal communication strategies and communication technologies, along with user-centred co-design that enables digital health autonomy will further progress towards reduced inequalities (SDG 10) and good health and well-being (SDG 3) and for people with communication or swallowing disability. [ABSTRACT FROM AUTHOR]

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Despite the well documented pragmatic deficits that can arise subsequent to Right Hemisphere Brain Damage (RHBD), few researchers have directly studied everyday conversations involving people with RHBD. In recent years, researchers have begun applying Conversation Analysis (CA) to the everyday talk of people with aphasia. This research programme has provided novel insights into the complex inter-relationship between impairment, language use, and interactional organization. This paper will argue that the detailed, inductive approach of CA is well suited to investigating pragmatic communication disorders resulting from RHBD, and will help to elaborate previous findings about RHBD and conversation. In particular, this paper will review and discuss previous investigations of conversation after RHBD, and put forward arguments relating to how CA might be applied to talk-in-interaction involving people with RHBD. [ABSTRACT FROM AUTHOR]

Objectives: Appropriate outcome measures are required for deaf children with severe (SLD) and profound and multiple learning difficulties (PMLD). This paper describes the development and structure of the Nottingham Early CaLL Framework and via a series of case-studies, demonstrates its effectiveness in tracking progress over time.Methods: The materials were developed in-house in 2011-2012 and refined through the exploration of established approaches in health and education, an inter-rater reliability study and an extended pilot of the draft materials.Results: The Framework quantifies the long term benefit of cochlear implantation by recording the amount of functional sound processor use achieved, alongside incremental changes in auditory behaviours, in the context of cognition, interaction and communication development. The case-studies demonstrate how it can provide evidence of measurable changes and help to explain some of the underlying reasons for the range of long-term outcomes.Discussion: Within this population, the key predictive, within-child factors of post cochlear implant listening and spoken language outcomes, are an individual's cognitive and physical capacities and their engagement in social communication.Conclusion: The Early CaLL Framework supports expectation counselling and decision-making in the assessment phase and post cochlear implantation provides monitoring tool, which encourages collaboration between families and professionals. [ABSTRACT FROM AUTHOR]

We focus this theoretical paper on a neglected distinction in tinnitus research between moderators and mediators of tinnitus distress. A moderator variable is one that influences the strength of a relationship between two other variables. In the paper we propose that several variables might act as moderators of tinnitus distress. Degree of hearing loss, arousal, insomnia, characteristics of tinnitus, noise sensitivity, and a range of psychological factors such as personality and perceived control are discussed as potential moderators. We then move on to mediator variables. A mediator variable is one that explains the relationship between the two other variables, and must by definition be caused by a predictor, and then mediate between the predictor and the dependent variable. We propose that stress levels (caused by tinnitus), classical conditioning, selective attention towards tinnitus, and psychological acceptance of tinnitus (versus experiential avoidance) might be mediators of distress. We encourage more research on moderators and mediators of tinnitus distress, as these will help illuminate treatment protocols and how they might work. [ABSTRACT FROM AUTHOR]