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"Language Therapy organization "
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Parent-Implemented Enhanced Milieu Teaching With Preschool Children Who Have Intellectual Disabilities
Purpose: The purpose of this study was to compare the effects of enhanced milieu teaching (EMT) implemented by parents and therapists versus therapists only on the language skills of preschool children with intellectual disabilities (IDs), including children with Down syndrome and children with autism spectrum disorders. Method: Seventy-seven children were randomly assigned to 2 treatments (parent + therapist EMT or therapist-only EMT) and received 36 intervention sessions. Children were assessed before, immediately after, 6 months after, and 12 months after intervention. Separate linear regressions were conducted for each standardized and observational measure at each time point. Results: Parents in the parent + therapist group demonstrated greater use of EMT strategies at home than untrained parents in the therapist-only group, and these effects maintained over time. Effect sizes for observational measures ranged from d = 0.10 to d = 1.32 favoring the parent + therapist group, with the largest effect sizes found 12 months after intervention. Conclusion: Findings from this study indicate generally that there are benefits to training parents to implement naturalistic language intervention strategies with preschool children who have ID and significant language impairments.
Journal Article
Description of an Intensive Residential Aphasia Treatment Program: Rationale, Clinical Processes, and Outcomes
The purpose of this article is to describe the rationale, clinical processes, and outcomes of an intensive comprehensive aphasia program (ICAP).
Seventy-three community-dwelling adults with aphasia completed a residentially based ICAP. Participants received 5 hr of daily 1:1 evidence-based cognitive-linguistically oriented aphasia therapy, supplemented with weekly socially oriented and therapeutic group activities over a 23-day treatment course. Standardized measures of aphasia severity and communicative functioning were obtained at baseline, program entry, program exit, and follow-up. Results were analyzed using a Bayesian latent growth curve model with 2 factors representing (a) the initial level and (b) change over time, respectively, for each outcome measure.
Model parameter estimates showed reliable improvement on all outcome measures between the initial and final assessments. Improvement during the treatment interval was greater than change observed across the baseline interval, and gains were maintained at follow-up on all measures.
The rationale, clinical processes, and outcomes of a residentially based ICAP have been described. ICAPs differ with respect to treatments delivered, dosing parameters, and outcomes measured. Specifying the defining components of complex interventions, establishing their feasibility, and describing their outcomes are necessary to guide the development of controlled clinical trials.
Journal Article
The complexities of designing therapy for Māori living with stroke-related communication disorders
Stroke-related communication disorders can have a substantial impact on Māori whānau (extended family). Timely and appropriate speech-language therapy is required, but there are many challenges in providing this. In this article we discuss the need for a kaupapa Māori approach to speech-language therapy that is designed by Māori for Māori, and undertaken in a Māori way. We report the results of a literature review that revealed a small but significant body of literature describing Māori experiences of stroke, aphasia and speech-language therapy, and evidence that a Māori-specific therapy programme can improve outcomes for people with stroke. We then consider the social and political context that impacts the design and delivery of such an approach. Informed by the literature, we propose a hierarchy of skill and resource acquisition for speech-language therapists, in which they learn why to be culturally safe, how to be culturally safe, and how to interact before creating resources to build relationships, resources for education and for therapy. The creation of a kaupapa Māori speech-language therapy approach should bring together people with stroke, whānau members and service providers to create therapy that crosses sectors and disciplines and acknowledges the wider social and political context.
Journal Article
Uncovering the theoretical underpinnings of an interprofessional preschool intervention program: Tumbling Together
Intervention programs are rarely tailored for children with self-regulation and communication challenges. Therefore, clinicians develop their own programs as is the case with the preschool program Tumbling Together. This program combines occupational therapy, speech-language therapy, and gymnastics.
The aim of this study was to take an in-depth look at the program to answer the following questions: (a) What are the fundamental concepts of the program? and (b) What is the underlying theoretical model that illustrates the relationships between concepts?
The qualitative research method of grounded theorizing using situational analysis was employed.
Fourteen main concepts of the program were identified and informed the development of a theoretical model.
A theoretical model incorporating Tumbling Togethers concepts is a first step in evaluating its efficacy. Although the concepts involved are not novel, their unique combination forms a promising intervention approach for this population.
Journal Article
Tensions in Commissioning: Services for Children's Speech, Language and Communication Needs in One English Region
Objectives
To investigate the tensions faced in commissioning services for children's speech, language and communication needs and to identify variation in commissioning practice in response to these tensions.
Methods
Quantitative and qualitative evidence from a review of speech, language and communication services in one English region, focused on three case studies.
Results
The case studies reveal variation in practice in relation to commissioning tensions generated by: low incidence/high needs cases, blurred boundaries between health and education, multi-agency working, parental voice and service development. The introduction of commissioning and models of practice such as ‘the commissioning cycle’ has left huge variation between localities in levels and type of provision for these services.
Conclusion
Large variation in commissioning practice is associated with commissioners' adoption of one of three models: a market model, an integrated model and a top-up model.
Journal Article
Struggling to Be Seen and Heard: The Underserved and Unserved Populations
Objective: The purpose of this paper is to provide some current information on the topic of the underserved and unserved populations including modern-day slaves, stateless/displaced persons, refugees/migrants and indigenous populations. Method: Speech-language pathology education and services for the underserved as well as unserved populations are discussed. Three case studies which demonstrate knowledge transfer and exchange as potential models for future development are presented. Conclusion: These case studies lead to more inquiries, studies, innovations and involvement from individuals and groups who are concerned about the underserved and unserved populations.
Journal Article
Language Intervention in the Classroom: What It Looks Like
By increasing the relevance of language intervention in this way, SLPs can help students gain a deeper understanding of classroom content and generalize what they learn from one setting to another. [...]SLPs will be able to share with teachers their expertise in language development, language disorders, and language intervention techniques- information that can benefit many students in a typical classroom. At the middle school where I observed, many students with language impairments were also receiving instruction in word decoding, spelling, and other written language skills from the special education teacher several times per week. [...]of open and ongoing communication with the SLP, the special education teacher was able to reinforce the students' use of the newly learned vocabulary words in their written assignments.
Journal Article
Mainstreaming Sure Start speech and language therapy services
Mainstreaming is the process of transferring policy, activity or good practice from a community-based initiative, such as Sure Start, into the core service. This paper will explain how one Sure Start programme developed a strategy for speech and language therapy (S<) that had an impact on the development of mainstream S< provision. The strategy explained here has shown the potential for team working and multi-agency delivery of new services. The new service was based on quality standard setting (as highlighted in government policy); positive multi-agency working based on sharing and skill development; and consumer involvement in a quality evaluation cycle. This paper discusses the different factors in developing and mainstreaming a Sure Start initiative. These critical processes have been applied to one local Sure Start programme as an example of these elements in action.
Journal Article
Analysis of Practice-role Perceptions of Physical Therapy, Occupational Therapy, and Speech-Language Therapy Students
The purpose of this study was to determine whether physical therapy (PT), occupational therapy (OT), and speech-language therapy (SLP) students shared common perceptions of the practice roles of the three disciplines The survey instrument used in this study contained 55 questions that addressed practice-role perceptions. The questions were based on a case study. A total of 172 undergraduate students (PT 71, OT 52, SLP 49) from a southeastern university participated. Chi-square test of association was used to analyze the data. Results showed that PT, OT, and SLP students shared common perceptions of administrative and educational practice roles but differed on their perceptions of assessment and physical/mental treatment roles. Practice-role confusion was particularly acute between OT and PT and between OT and SLP students in these areas.
Journal Article