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Purpose This study examined the effect of Vocabulary Acquisition and Usage for Late Talkers (VAULT) treatment on toddlers' expressive vocabulary and phonology. Parent acceptability of VAULT treatment was also considered. Method We used a nonconcurrent multiple baseline single case experimental design with three late talking toddlers aged 21–25 months. The treatment was delivered twice weekly in 30-min sessions for 8 weeks by a rotating team of four speech-language pathologists. Toddlers heard three of their 10 strategically selected target words a minimum of 64 times in play activities each session. Expressive vocabulary and phonology was assessed pre–post, with parent interviews conducted posttreatment. Results All toddlers increased production of target words and expressive vocabulary. Ambient expressive vocabulary size increased by an average of 16 words per week (range of 73–169 words learned over the treatment period). On a 20-item, single-word speech assessment, the toddlers' phonetic inventories increased on average from three to seven consonants, and five to eight vowels. Two toddlers used protowords pretreatment, which were replaced by recognizable attempts at words posttreatment. Parents reported the treatment was acceptable for the child and their family with future consideration of parent-based delivery of the treatment in the home. Conclusions The results of this treatment provide further evidence of a model of intervention informed by the principles of implicit learning, and the interconnectedness of phonological and lexical learning. Investigation is required to establish the efficacy and feasibility of VAULT in clinical contexts. Supplemental Material https://doi.org/10.23641/asha.14714733

Purpose: The current landscape of speech-language pathology (SLP) services for 12- to 16-year olds in Australia remains largely unchartered. Implementing the Speech Pathology 2030 vision necessitat...

Purpose Working with students with emotional behavioral disorders is a challenging area of speech-language pathology practice. In this study, we compare and profile the narrative discourse, structural language, and social communication characteristics of adolescents attending behavioral support and mainstream schools. We also examine relationships between narratives, structural language, social communication, and behavior. Method Fifty-four students aged between 12 and 16 years participated. Twenty-seven students were from 3 Australian government Schools for Specific Purposes for students with behavioral difficulties, and 27 typically developing students were from a mainstream, government school. Students were matched for age and closely matched for sex and socioeconomic status. All students completed 3 communication assessments: oral narrative, structural language, and social communication skills. Teachers were asked to complete 2 behavioral questionnaires. Results Students in behavioral schools had significant difficulties generating narratives. Their structural language and overall social communication skills were also significantly poorer than their mainstream peers. One third of the behavioral group experienced significant difficulties across all 3 of these communication areas. Externalizing behavior was significantly related to narrative, structural language, and social communication only when the data were pooled across both groups. Conclusions Language and social communication difficulties were evident in adolescents who attend alternative school settings—behavioral schools. These findings confirm the need for speech-language pathologists to be engaged in specialist behavioral schools and provide impetus to service providers, speech-language pathologists, and educators to address relationships between behavior and communication ability.

We evaluated the MULTILIT—“Making Up Lost Time in Literacy”—instruction program for individuals with Down syndrome. The 12-week program was administered on a 1:1 basis to participants who were assessed at three timepoints: Baseline, pre-instruction, and post-instruction. Participants were allocated non-randomly to two groups that had comparable abilities prior to intervention. These groups differed in the duration of the control period between baseline and pre-instruction: 12 weeks for Group 1 (n = 8, mean age = 168.88 months) and 24 weeks for Group 2 (n = 7, mean age = 164.71 months). Improvements in literacy skills were evaluated within participants (each participant serving as her/his own control), and the influence of control periods was evaluated between participants. Phonological awareness, word reading accuracy, and word spelling accuracy all improved significantly from pre- to post-instruction, with large effect sizes; whereas no statistically significant changes were observed during the control period (between baseline and pre-instruction assessments) regardless of the duration of this control period.

Purpose: Given the barriers that inconsistent terminology poses for the Speech-Language Pathology (SLP) profession, this study aimed to develop an agreed-upon taxonomy with well-defined categories for describing language assessment practices for children. Method: A taxonomy with illustrative terms for describing assessments across four aspects (modality/domain, purpose, delivery and form) was developed with reference to contemporary literature. In a three round Delphi study, SLPs with expertise in child language were asked to indicate their level of agreement with the taxonomy and provide feedback. Participants were also asked to apply the taxonomy by categorising assessments presented in case studies. Result: A total of 55 participants completed round one, while 43 and 32 completed rounds two and three respectively. Agreed consensus with the taxonomy was achieved in both rounds one and two, with at least 88% of participants agreeing with each aspect and 100% agreeing with the overall structure. In round three, an agreement was reached on 7/10 components for one case study and 4/10 for the other. Conclusion: The development of this taxonomy represents a significant step towards providing detailed terminology for describing language assessments. Future research is needed to investigate implementation strategies to facilitate consistent application of the taxonomy by SLPs.

Background When planning evidence-based intervention services for children with phonology-based speech sound disorders (SSD), speech and language therapists (SLTs) need to integrate research evidence regarding service delivery and intervention intensity within their clinical practice. However, relatively little is known about the optimal intensity of phonological interventions and whether SLTs' services align with the research evidence. Aims The aims are twofold. First, to review external evidence (i.e., empirical research evidence external to day-to-day clinical practice) regarding service delivery and intervention intensity for phonological interventions. Second, to investigate SLTs' clinical practice with children with phonology-based SSD in Australia, focusing on service delivery and intensity. By considering these complementary sources of evidence, SLTs and researchers will be better placed to understand the state of the external evidence regarding the delivery of phonological interventions and appreciate the challenges facing SLTs in providing evidence-based services. Methods & procedures Two studies are presented. The first is a review of phonological intervention research published between 1979 and 2016. Details regarding service delivery and intervention intensity were extracted from the 199 papers that met inclusion criteria identified through a systematic search. The second study was an online survey of 288 SLTs working in Australia, focused on the service delivery and intensity of intervention provided in clinical practice. Main contributions There is a gap between the external evidence regarding service delivery and intervention intensity and the internal evidence from clinical practice. Most published intervention research has reported to provide intervention two to three times per week in individual sessions delivered by an SLT in a university clinic, in sessions lasting 30-60 min comprising 100 production trials. SLTs reported providing services at intensities below that found in the literature. Further, they reported workplace, client and clinician factors that influenced the intensity of intervention they were able to provide to children with phonology-based SSD. Conclusions & implications Insufficient detail in the reporting of intervention intensity within published research coupled with service delivery constraints may affect the implementation of empirical evidence into everyday clinical practice. Research investigating innovative solutions to service delivery challenges is needed to provide SLTs with evidence that is relevant and feasible for clinical practice.

The narrative skills of children with brain tumours were examined. Influence of tumour location, radiotherapy, time post-treatment and presence of hydrocephalus was also investigated, as well as associations between narrative and language abilities.Seventeen children (aged 5;6-14;11) treated for brain tumour and their matched controls completed a narrative assessment and comprehensive language testing. Audio recorded narratives were analysed for microstructure and macrostructure elements. Between-group comparisons were conducted. Narrative elements were explored in association with tumour and treatment-related variables. Correlation analysis examined relationships between narrative scores and language test performance.While significant differences were not found between two groups of children across narrative elements, sub-group comparisons revealed marginal differences in macrostructure related to tumour location and hydrocephalus. Children treated with methods other than radiotherapy showed a significant increase in number of mazes in their narratives compared to children who received radiotherapy. Strong positive correlations also existed between narrative elements and language performance.Preliminary findings highlight the importance of investigating narrative abilities as part of a comprehensive language assessment. Macrostructure should be routinely examined where children are diagnosed with either posterior fossa tumour or hydrocephalus or have undergone surgery and/or chemotherapy for brain tumour.

To determine whether the developing semantic lexicon varies with culture, we examined the animal and food naming of children from three communities distinguished by language, cultural heritage, and population density. The children were five- and seven-year-olds from Australia (n = 197), Taiwan (n = 456), and the US (n = 172). Naming patterns revealed hierarchical and flexible organization of the semantic lexicon. The content of the lexicon, particularly food names, varied with cultural heritage. In all three communities, wild mammals were predominant during animal naming, a likely influence of children's media. The influence of the Chinese zodiac was evident in the clustering of animal names in the Taiwanese sample. There was no apparent influence of population density and little influence of language, except that the Taiwanese children more frequently named foods at the superordinate level, a possible influence of the structure of Mandarin. Children develop their lexicons in response to culture as experienced first-hand or through media.

Background Internationally, speech and language therapists (SLTs) are involving parents and providing home tasks in intervention for phonology-based speech sound disorder (SSD). To ensure that SLTs’ involvement of parents is guided by empirical research, a review of peer-reviewed published evidence is needed. Aims To provide SLTs and researchers with a comprehensive appraisal and analysis of peer-reviewed published intervention research reporting parent involvement and the provision of home tasks in intervention studies for children with phonology-based SSD. Methods & Procedures A systematic search and review was conducted. Academic databases were searched for peer-reviewed research papers published between 1979 and 2013 reporting on phonological intervention for SSD. Of the 176 papers that met the criteria, 61 were identified that reported on the involvement of parents and/or home tasks within the intervention. These papers were analysed using a quality appraisal tool. Details regarding the involvement of parents and home tasks were extracted and analysed to provide a summary of these practices within the evidence base. Main Contribution Parents have been involved in intervention research for phonology-based SSD. However, most of the peer-reviewed published papers reporting this research have provided limited details regarding what this involved. This paucity of information presents challenges for SLTs wishing to integrate external evidence into their clinical services and clinical decision-making. It also raises issues regarding treatment fidelity for researchers wishing to replicate published intervention research. Conclusions & Implications The range of tasks in which parents were involved, and the limited details reported in the literature, present challenges for SLTs wanting to involve parents in intervention. Further high-quality research reporting more detail regarding the involvement of parents and home tasks in intervention for SSD is needed.

Early identification of severe/profound childhood hearing loss (HL) gives these children access to hearing devices and early intervention to facilitate improved speech and language outcomes. Predicting which infants will go on to achieve such outcomes remains difficult. This study describes clinician identified malleable and non-malleable factors that may influence speech and language outcomes for children with severe/profound HL.Semi-structured interviews were conducted with six experienced auditory verbal clinicians. A collective case study design was implemented. The interviews were transcribed and coded into themes using constant comparative analysis.Clinicians identified that, for children with severe/profound HL, early identification, early amplification and commencing auditory-verbal intervention under 6 months of age may facilitate child progress. Possible barriers were living in rural/remote areas, the clinicians' lack of experience and confidence in providing intervention for infants under age 6-months and belonging to a family with a culturally and linguistically diverse (CALD) background.The results indicate that multiple factors need to be considered by clinicians working with children with HL and their families to determine how each child functions within their own environment and personal contexts, consistent with the International Classification of Functioning, Disability and Health (ICF) framework. Such an approach is likely to empower clinicians to carefully balance potential barriers to, and facilitators of, optimal speech and language outcomes for all children with HL.

Communication and play skills are important aspects of development yet are largely uncharted in children with attention deficit hyperactivity disorder (ADHD). This exploratory study examined whether changes in pragmatic skills and problem-solving skills were observed in children with ADHD pre- and post-participation in a play-based intervention conducted by occupational therapists and speech-language pathologists. The study also investigated whether the presence of language difficulties affected the children’s play outcomes. Fourteen children with ADHD (5;0–10;7 years) participated in a 7-week, pilot intervention to address play and social skill deficits. Pre- and post-intervention testing included: (a) the assessment of play and problem-solving skills via standardized testing, and (b) pragmatic skills via parent report. The children’s language skills were also screened and compared with their play scores. Play skills significantly improved post-intervention. No significant differences were observed for pragmatic skills while prediction skills, an aspect of problem-solving, significantly improved pre- and post-play-based intervention. Fifty percent of children failed the language screener, yet separate paired t-tests identified significant play improvements irrespective of the presence or absence of language difficulty. Two independent t-tests revealed significant differences in play scores between these groups at pre- but not post-intervention. While play and predicting skills significantly improved post-play-based intervention, other aspects of problem-solving and pragmatics did not. Reasons for the lack of change in these areas are discussed. The presence of language difficulties did not appear to affect the play outcomes of children with ADHD following a play-based intervention. A larger scale experimental trial investigating the play and language skills of children with ADHD is warranted, as is future collaborative research between occupational therapists and speech-language pathologists in the assessment and management of children with ADHD.

Background speechBITE (http://www.speechbite.com) is an online database established in order to help speech and language therapists gain faster access to relevant research that can used in clinical decision-making. In addition to containing more than 3000 journal references, the database also provides methodological ratings on the PEDro-P (an adapted version of the PEDro) scale to assist clinicians in identifying the scientific quality of randomized (RCTs) and non-randomized control trials (NRCTs). While reliability of the PEDro scale has been established by similar allied health databases, the reliability of the PEDro-P scale has yet to be reported. Aims To examine the reliability of PEDro-P scale ratings undertaken by raters on the speechBITE database and benchmark these results to the published reliability for the original PEDro scale. Both the total score (out of ten) as well as each of the 11 scale items were included in this analysis. Methods & Procedures speechBITE's volunteer rater network of 17 members rated the first 100 RCTs and NRCTs on the website. The criterion and overall scores for these ratings were compared with previously published reliability studies using the PEDro scale. Intra-class correlations and per cent agreement measures were used to establish and benchmark reliability. Outcomes & Results The speechBITE PEDro-P ratings ranged from fair to excellent for both the total score and for each of the 11 scale items. Furthermore, reliability was equal to that of other databases. Conclusions & Implications speechBITE users can be confident of the reliability of ratings published on the website. Further analysis of differences between this study and previous PEDro scale reliability studies are discussed.

Age-appropriate speech/language outcomes for children with early identified hearing loss are a possibility but not a certainty. Identification of children most likely to achieve optimal outcomes is complicated by the heterogeneity of the children involved in outcome research, who present with a range of malleable (e.g. age of identification and cochlear implantation, type of intervention, communication mode) and non-malleable (e.g. degree of hearing loss) factors. This study considered whether a homogenous cohort of early identified children (≤ 12 months), with all severities of hearing loss and no other concomitant diagnoses could not only significantly outperform a similarly homogenous cohort of children who were later identified (12 months to5 years), but also achieve and maintain age-appropriate speech/language outcomes by 3, 4 and 5 years of age.A mixed prospective/retrospective comparative study of a homogenous cohort of 45 early identified (≤ 12 months) and 49 late identified (12 months to5 years) children with hearing loss was conducted. The children all attended the same oral auditory-verbal early intervention programme. Speech/language assessments standardized on typically developing hearing children were conducted at 3, 4 and 5 years of age.The early identified children significantly outperformed the late identified at all ages and for all severities of HL. By 3 years of age, 93% of all early identified participants scored within normal limits (WNL) for speech; 90% were WNL for understanding vocabulary; and 95% were WNL for receptive and expressive language. Progress was maintained and improved so that by 5 years of age, 96% were WNL for speech, with 100% WNL for language.This study found that most children with all severities of hearing loss and no other concomitant diagnosed condition, who were early diagnosed; received amplification by 3 months; enrolled into AV intervention by 6 months and received a cochlear implant by 18 months if required, were able to "keep up with" rather than "catch up to" their typically hearing peers by 3 years of age on measures of speech and language, including children with profound hearing loss. By 5 years, all children achieved typical language development and 96% typical speech.

Purpose This study evaluated the efficacy of a collaborative intervention where a speech-language pathologist (SLP) trained mainstream secondary school teachers to make modifications to their oral and written instructional language. The trained teachers' uptake of techniques in their whole-class teaching practices and the impact this had on the language abilities of students with language impairment (LI) were evaluated. Method Two secondary schools were randomly assigned to either a trained or a control condition. A cohort of 13 teachers (7 trained and 6 control) and 43 Year 8 students with LI (21 trained and 22 control) were tested at pre, post, and follow-up times—teachers by structured interview and students by standardized spoken and written language assessments. Results Significantly increased use of the language modification techniques by the trained teachers was observed when compared to the control group of untrained teachers, with this increased use maintained over time. Results from the trained group of students showed a significant improvement in written expression and listening comprehension relative to the control group of students. Conclusion This randomized controlled trial is one of the first investigations to evaluate a collaborative intervention that links changes in mainstream secondary teachers' instructional language practices with improvements in the language abilities of adolescents with LI.

With more children attending formal child care and limited speech language pathology resources, there is a need to consider alternate service delivery models. One such approach is clinician training of early childhood professionals (ECPs). To be appropriately targeted and efficient, training programs should be based on research evidence. This systematic review focuses on studies into which ECP skills improve child language and literacy. Databases searched were PsychINFO, Scopus, Web of Science, CINAHL, ERIC, LLBA, and Medline from 1990 onwards. Papers were included if they were (a) studies reporting the efficacy of professional development programs in terms of positive outcomes for both child and ECP, or (b) longitudinal or cross-sectional experimental investigations that examined the relation between ECP skills and child language/literacy outcomes. The initial search identified 212 potential studies with 34 studies meeting the inclusion criteria. These 34 studies included 2 longitudinal, 1 descriptive, and 31 cross-sectional experiments (16 randomized controlled trials, RCTs; 15 non-RCTs). The review identified four key skill categories: (a) quality adult–child interactions; (b) explicit literacy instruction; (c) storytelling skills; and (d) supporting peer-to-peer interactions. The inclusion of these skills by clinicians in training of ECPs is supported by research evidence.

Consideration of client values and preferences for service delivery is integral to engaging with the evidence-based practice triangle (E(3)BP), but as yet such preferences are under-researched. This exploratory study canvassed paediatric speech-language pathology services around Australia through an online survey of parents and compared reported service delivery to preferences, satisfaction, and external research evidence on recommended service delivery. Respondents were 154 parents with 192 children, living across a range of Australian locations and socio-economic status areas. Children had a range of speech and language disorders. A quarter of children waited over 6 months to receive initial assessment. Reported session type, frequency, and length were incongruent with both research recommendations and parents' wishes. Sixty per cent of parents were happy or very happy with their experiences, while 27% were unhappy. Qualitative responses revealed concerns such as; a lack of available, frequent, or local services, long waiting times, cut-off ages for eligibility, discharge processes, and an inability to afford private services. These findings challenge the profession to actively engage with E(3)BP including; being cognisant of evidence-based service delivery literature, keeping clients informed of service delivery policies, individualizing services, and exploring alternative service delivery methods.

This scoping study investigated how evidence-based practice (EBP) principles are taught in Australian speech-language pathology (SLP) teaching and learning contexts. It explored how Australian SLP university programs: (1) facilitate student learning about the principles of EBP in academic and clinical settings, and (2) self-evaluate their curricula in relation to EBP. The research involved two surveys. Survey 1 respondents were 131 academic staff, program coordinators, and on-campus and off-campus clinical educators. This survey gathered information about EBP teaching and learning in SLP programs as well as future EBP curriculum plans. Survey 2 investigated how clinical educators incorporated EBP into the way they taught clinical decision-making to students. Surveys responses from 85 clinical educators were analysed using descriptive and non-parametric statistics and thematic grouping of open-ended qualitative responses. Both surveys revealed strengths and gaps in integrating EBP into Australian SLP curricula. Perceived strengths were that respondents were positive about EBP, most had EBP training and access to EBP resources. The perceived gaps included the academic staff's perceptions of students' understanding and application of EBP, respondents' understanding of research methodologies, communication and collaboration between academic staff and clinical educators, and a lack of explicit discussion by clinical educators and students of EBP in relation to clients.

Up to 16% of students in mainstream secondary schools present with language impairment (LI). As with other learning difficulties, students with LI experience many academic, social, emotional and behavioral problems. Associated presenting behaviors may, however, be masking the primary language impairment. As a result, secondary school students with LI are under-recognised and may therefore be missing out on appropriate supports and services. In order to increase the awareness of education professionals and to increase the likelihood of identification and effective support, this article describes the nature and impact of LI in secondary school student populations. Two hypothetical case studies highlight the educational and psychosocial impact of LI during adolescence.

This paper describes the development of the Speech Pathology Database for Best Interventions and Treatment Efficacy (speechBITE) at The University of Sydney. The speechBITE database is designed to provide better access to the intervention research relevant to speech pathology and to help clinicians interpret treatment research. The challenges speech pathologists face when locating research to support evidence-based practice have been well documented and include inadequate time resources and difficulties in navigating and using a multiplicity of electronic databases. These barriers are addressed by speechBITE by providing the first open-access database on the internet that solely indexes treatment in the area of communication and swallowing disorders. The database includes the bibliographic details from systematic reviews, randomized controlled trials, nonrandomized controlled trials, case series, and single-case experimental design studies. At present, randomized and nonrandomized controlled trials are ra...