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Purpose: The purposes of this study were to examine the self-efficacy of school-based speech-language pathologists (SLPs) in conducting multidimensional treatment with children who stutter (CWS) and to identify correlates of self-efficacy in treating speech-related, social, emotional, and cognitive domains of stuttering. Method: Three hundred twenty randomly selected school-based SLPs across the United States responded to an online survey that contained self-efficacy scales related to speech, social, emotional, and cognitive components of stuttering. These ratings were analyzed in relation to participants' beliefs about stuttering treatment and their comfort level in treating CWS, perceived success in therapy, and empathy levels, in addition to their academic and clinical training in fluency disorders as well as demographic information. Results: Overall, SLPs reported moderate levels of self-efficacy on each self-efficacy scale and on a measure of total self-efficacy. Significant positive associations were observed between SLPs' self-efficacy perceptions and their comfort level in treating CWS, self-reported success in treatment, beliefs about the importance of multidimensional treatment, and self-reported empathy. There were some discrepancies between what SLPs believed was important to address in stuttering therapy and how they measured success in therapy. Conclusions: Among school-based SLPs, self-efficacy for treating school-age CWS with a multidimensional approach appears stronger than previously reported; however, more progress in training and experience is needed for SLPs to feel highly self-efficacious in these areas. Continuing to improve clinician self-efficacy for stuttering treatment through improved academic training and increased clinical experiences should remain a high priority in order to enhance outcomes for CWS.

This exciting new text offers a comprehensive, engaging, and readable overview to the dynamic field of medical speech-language pathology. It is the first medical speech-language pathology textbook that is not focused on the various disorders, but instead examines the scope and key concepts of the profession, such as clinical reasoning, interprofessional practice, and the continuum of care. The book provides an in-depth overview of health care workplace settings (acute care, inpatient rehabilitation, skilled nursing, home health, outpatient care, pediatric service delivery, pharmacology, and neuroimaging).

Purpose: Single-subject experimental designs (SSEDs) represent an important tool in the development and implementation of evidence-based practice in communication sciences and disorders. The purpose of this article is to review the strategies and tactics of SSEDs and their application in speech-language pathology research. Method: The authors discuss the requirements of each design, followed by advantages and disadvantages. The logic and methods for evaluating effects in SSED are reviewed as well as contemporary issues regarding data analysis with SSED data sets. Examples of challenges in executing SSEDs are included. Specific exemplars of how SSEDs have been used in speech-language pathology research are provided throughout. Conclusion: SSED studies provide a flexible alternative to traditional group designs in the development and identification of evidence-based practice in the field of communication sciences and disorders. (Contains 2 tables and 8 figures.)

The aim of this study was to provide a cross-linguistic review of acquisition of consonant phonemes to inform speech-language pathologists' expectations of children's developmental capacity by (a) identifying characteristics of studies of consonant acquisition, (b) describing general principles of consonant acquisition, and (c) providing case studies for English, Japanese, Korean, and Spanish. A cross-linguistic review was undertaken of 60 articles describing 64 studies of consonant acquisition by 26,007 children from 31 countries in 27 languages: Afrikaans, Arabic, Cantonese, Danish, Dutch, English, French, German, Greek, Haitian Creole, Hebrew, Hungarian, Icelandic, Italian, Jamaican Creole, Japanese, Korean, Malay, Maltese, Mandarin (Putonghua), Portuguese, Setswana (Tswana), Slovenian, Spanish, Swahili, Turkish, and Xhosa. Most studies were cross-sectional and examined single word production. Combining data from 27 languages, most of the world's consonants were acquired by 5;0 years;months old. By 5;0, children produced at least 93% of consonants correctly. Plosives, nasals, and nonpulmonic consonants (e.g., clicks) were acquired earlier than trills, flaps, fricatives, and affricates. Most labial, pharyngeal, and posterior lingual consonants were acquired earlier than consonants with anterior tongue placement. However, there was an interaction between place and manner where plosives and nasals produced with anterior tongue placement were acquired earlier than anterior trills, fricatives, and affricates. Children across the world acquire consonants at a young age. Five-year-old children have acquired most consonants within their ambient language; however, individual variability should be considered. https://doi.org/10.23641/asha.6972857.

Purpose: This article examines use of language sample analysis (LSA) by school-based speech-language pathologists (SLPs), including characteristics of language samples, methods of transcription and analysis, barriers to LSA use, and factors affecting LSA use, such as American Speech-Language-Hearing Association certification, number of years' experience, and caseload characteristics. Method: School-based SLPs responded to an invitation to complete an electronic survey related to LSA. Results: One third of respondents indicated they did not use LSA during the 2012-2013 school year. SLPs who served middle and high school students were less likely to use LSA. Most respondents reported using conversation to analyze fewer than 10 samples and transcribing in real time. Additional analyses revealed that SLPs who had 3 or fewer years of experience and who analyzed fewer than 20 language samples per year were statistically less likely to report using real-time transcription. The most frequently cited barrier to using LSA was \"LSA is too time-consuming.\" Conclusion: Many school-based SLPs do not routinely use LSA. Further, many did not report engaging in evidence-based practices, such as recording samples, using established protocols, or using tasks designed to elicit complex syntax. These results indicate a continued need for professional development regarding evidenced-based practices relative to LSA use.

Purpose: For over two decades, we have known that children with developmental language disorder (DLD) are underserved. We have also known that DLD does not attract the research attention that it merits given its prevalence and impact. The purposes of this clinical focus article are to present evidence that these failures continue, explore the reasons behind these failures, and propose solutions. Method: I reviewed the literature and applied bibliometric analysis procedures from Bishop (2010) to quantify research efforts aimed at DLD compared to other neurodevelopmental disorders. Results: The percentage of children who are deemed eligible for clinical services because of DLD continues to fall well short of estimates based on the prevalence of DLD in community samples. The amount of research conducted on DLD relative to other neurodevelopmental disorders remains low. Contributing factors include a lack of awareness of DLD, the hidden nature of DLD, entrenched policies, and the dissonance created when speech-language pathologists must diagnose DLD in school settings. Conclusions: Expanded approaches to supporting children with DLD are required. These might include engagement in advocacy and awareness campaigns; clearer communication with the families we serve and enhanced collaborations with classroom teachers; the implementation of school-based language screenings; participation in policymaking; and the development of service delivery models that operate alongside those that exist in our schools and complement their function.

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

Purpose: Speech-language pathologists (SLPs) in the schools provide services to students with a variety of disorders and severity levels. This study built upon a previously published survey (Brandel & Loeb, 2011) to examine whether factors related to the place and time for services for students with language disorders had changed since the 2008 survey and to examine the differentiation of decisions made by the SLPs across the three severity levels. Method: Responses from 439 SLPs to an online national survey related to the place and time of services for students with language disorders were examined using regression in regard to the current factors impacting service delivery and the amount of variation in these decisions by the individual SLPs across the three severity levels. Results: Similar to previous findings, students participated in services primarily in groups outside the classroom once or twice a week for 20-30 min. Factors that continued to impact decisions were the SLP's caseload and year of graduation. Related to the differentiation of decisions, most SLPs made two different decisions across the three severity levels for where and how long to provide services, while almost one third made the same decision for the place. Conclusions: The results indicate that service delivery and the factors impacting it have remained relatively the same. While most SLPs do differentiate decisions related to time, less variation is observed regarding the place for services. Research is needed to clearly identify barriers and test possible solutions so that school practice can improve.

Purpose: This article introduces implementation science, which focuses on research methods that promote the systematic application of research findings to practice. Method: The narrative defines implementation science and highlights the importance of moving research along the pipeline from basic science to practice as one way to facilitate evidence-based service delivery. This review identifies challenges in developing and testing interventions in order to achieve widespread adoption in practice settings. A framework for conceptualizing implementation research is provided, including an example to illustrate the application of principles in speech-language pathology. Last, the authors reflect on the status of implementation research in the discipline of communication sciences and disorders. Conclusions: The extant literature highlights the value of implementation science for reducing the gap between research and practice in our discipline. While having unique principles guiding implementation research, many of the challenges and questions are similar to those facing any investigators who are attempting to design valid and reliable studies. This article is intended to invigorate interest in the uniqueness of implementation science among those pursuing both basic and applied research. In this way, it should help ensure the discipline's knowledge base is realized in practice and policy that affects the lives of individuals with communication disorders.

Purpose: To provide a primer regarding treatment fidelity as it affects evidence-based practice (EBP) for speech-language pathologists. Method: This tutorial defines treatment fidelity, examines the role of treatment fidelity for speech-language pathologists, provides examples of fidelity measurement, and describes approaches for assessing treatment fidelity. Conclusion: Treatment fidelity is a neglected construct in the EBP literature; however, fidelity is a crucial construct for documenting intervention effectiveness and engaging in EBP. (Contains 1 table.)