Children with speech and language communication needs in England: Challenges for practice

Teachers and speech and language therapists (SLTs) share concern about children’s speech, language, and communication needs (SLCNs) but they have different foci because of their professional roles. Contemporary research has identified the challenges to schools when meeting the needs of children with SLCN, highlighted terminological controversies, and has increased opportunities for professional development. The views of 170 Educationalists and SLT professionals in England about SLCN, and the children’s associated needs were compared for similarities and differences in an online survey that employed both categorical responses and Likert scales. Comparisons were made between teacher and SLT groups and between SLTs working in schools and clinics. There were few significant differences between the views of SLTs in clinics and education. In contrast, there were often large and significant differences between teachers and SLTs. Education professionals were less familiar with terminology related to speech difficulties, did not discriminate between behaviors that might differentiate speech from language difficulties and varied in the ratings given about other associated difficulties. Additionally, education professionals showed awareness of academic and behavior difficulties associated with language difficulties and highlighted associated problems with reading and writing. SLTs felt confident in their understanding of the relevant terminology but there was less clarity in the features that discriminated speech from language difficulties. Both the Educationalists and SLTs valued additional training needs with over 50% of the Education staff reporting that they had no training in SLCN. The lack of clarity about the language markers of SLCN by teachers and the requests for tools to help in the identification of speech and language problems in school-age children are important areas to address. Both SLTs and Education staff emphasized the co-occurrence of difficulties with reading comprehension and written text production, highlighting the importance of profiling children’s language learning needs rather than a reliance on diagnostic categories

Assessing speech, language and communication difficulties in children referred for ADHD: a qualitative evaluation of a UK child and adolescent mental health service

Background: Attention-deficit hyperactivity disorder (ADHD) is one of the most common childhood neuropsychiatric disorders and is highly comorbid with speech, language and communication difficulties (SLCDs). However, it is unclear how often SLCDs are identified in ADHD referrals in routine practice and whether there are unidentified SLCDs within this population. Method: A thematic analysis was conducted on a random sample of case notes from 18 referrals for ADHD made to a child and adolescent mental health service (CAMHS) in London, United Kingdom. Analyses aimed to identify (a) the types of SLCDs detected during assessment, (b) at which point of the episode of care these SLCDs were suspected and (c) whether a referral or consultation was made to a speech and language therapist (SLT) for further evaluation. Results: Out of 18 cases investigated, 15 were found to have possible SLCDs based on case notes and reports provided by external agencies. However, only four were referred by CAMHS for further assessment. It is unclear what, if any, steps other external agencies took. Themes describing types of SLCDs, comorbidities and the process of identification are discussed. Conclusion: The analysis of this service’s case notes revealed a range of different routes to the identification of SLCDs, and it was unclear what steps were taken as a result of assessment. A limitation is that this is just one service and the results may not generalise. However, given the similarity in practitioner training received across the country and that practitioners move from service to service, there are grounds for repeating the study in other services. We recommend a more structured approach to identifying SLCDs and recording assessment and treatment decisions made

Supporting thinking on sample sizes for thematic analyses: a quantitative tool

Thematic analysis is frequently used to analyse qualitative data in psychology, healthcare, social research and beyond. An important stage in planning a study is determining how large a sample size may be required, however current guidelines for thematic analysis are varied, ranging from around 2 to over 400 and it is unclear how to choose a value from the space in between. Some guidance can also not be applied prospectively. This paper introduces a tool to help users think about what would be a useful sample size for their particular context when investigating patterns across participants. The calculation depends on (a) the expected population theme prevalence of the least prevalent theme, derived either from prior knowledge or based on the prevalence of the rarest themes considered worth uncovering, e.g. 1 in 10, 1 in 100; (b) the number of desired instances of the theme; and (c) the power of the study. An adequately powered study will have a high likelihood of finding sufficient themes of the desired prevalence. This calculation can then be used alongside other considerations. We illustrate how to use the method to calculate sample size before starting a study and achieved power given a sample size, providing tables of answers and code for use in the free software, R. Sample sizes are comparable to those found in the literature, for example to have 80% power to detect two instances of a theme with 10% prevalence, 29 participants are required. Increasing power, increasing the number of instances or decreasing prevalence increases the sample size needed. We do not propose this as a ritualistic requirement for study design, but rather as a pragmatic supporting tool to help plan studies using thematic analysis

Combustion 2000

This report is a presentation of work carried out on Phase II of the HIPPS program under DOE contract DE-AC22-95PC95144 from June 1995 to March 2001. The objective of this report is to emphasize the results and achievements of the program and not to archive every detail of the past six years of effort. These details are already available in the twenty-two quarterly reports previously submitted to DOE and in the final report from Phase I. The report is divided into three major foci, indicative of the three operational groupings of the program as it evolved, was restructured, or overtaken by events. In each of these areas, the results exceeded DOE goals and expectations. HIPPS Systems and Cycles (including thermodynamic cycles, power cycle alternatives, baseline plant costs and new opportunities) HITAF Components and Designs (including design of heat exchangers, materials, ash management and combustor design) Testing Program for Radiative and Convective Air Heaters (including the design and construction of the test furnace and the results of the tests) There are several topics that were part of the original program but whose importance was diminished when the contract was significantly modified. The elimination of the subsystem testing and the Phase III demonstration lessened the relevance of subtasks related to these efforts. For example, the cross flow mixing study, the CFD modeling of the convective air heater and the power island analysis are important to a commercial plant design but not to the R&D product contained in this report. These topics are of course, discussed in the quarterly reports under this contract. The DOE goal for the High Performance Power Plant System ( HIPPS ) is high thermodynamic efficiency and significantly reduced emissions. Specifically, the goal is a 300 MWe plant with > 47% (HHV) overall efficiency and {le} 0.1 NSPS emissions. This plant must fire at least 65% coal with the balance being made up by a premium fuel such as natural gas. To achieve these objectives requires a change from complete reliance of coal-fired systems on steam turbines (Rankine cycles) and moving forward to a combined cycle utilizing gas turbines (Brayton cycles) which offer the possibility of significantly greater efficiency. This is because gas turbine cycles operate at temperatures well beyond current steam cycles, allowing the working fluid (air) temperature to more closely approach that of the major energy source, the combustion of coal. In fact, a good figure of merit for a HIPPS design is just how much of the enthalpy from coal combustion is used by the gas turbine. The efficiency of a power cycle varies directly with the temperature of the working fluid and for contemporary gas turbines the optimal turbine inlet temperature is in the range of 2300-2500 F (1260-1371 C). These temperatures are beyond the working range of currently available alloys and are also in the range of the ash fusion temperature of most coals. These two sets of physical properties combine to produce the major engineering challenges for a HIPPS design. The UTRC team developed a design hierarchy to impose more rigor in our approach. Once the size of the plant had been determined by the choice of gas turbine and the matching steam turbine, the design process of the High Temperature Advanced Furnace (HITAF) moved ineluctably to a down-fired, slagging configuration. This design was based on two air heaters: one a high temperature slagging Radiative Air Heater (RAH) and a lower temperature, dry ash Convective Air Heater (CAH). The specific details of the air heaters are arrived at by an iterative sequence in the following order:-Starting from the overall Cycle requirements which set the limits for the combustion and heat transfer analysis-The available enthalpy determined the range of materials, ceramics or alloys, which could tolerate the temperatures-Structural Analysis of the designs proved to be the major limitation-Finally the commercialization issues of fabrication and reliability, availability and maintenance. The program that has sought to develop and implement these HIPPS designs is outlined below

Changing Relationships through Interactions: Preliminary Accounts of Parent-Child Interactions after Undertaking Individual Parent Training

Purpose: Parent and child interaction training has been increasingly investigated over recent years. However, the mechanisms of change within individual training programmes are not well understood. To explore the factors that can facilitate or inhibit meaningful changes in interactions and ultimately relationships, the current study employed semi-structured interviews to obtain first person accounts from parents who had undertaken an individualised parent-training programme. Method: Three participants provided accounts of the training programme and their perceived impact upon interactions with their children were analysed using inductive thematic analysis. Results: The analysis resulted in three themes, which illustrate how participants adjusted their interactional style with their child to varying degrees through enhanced personal awareness, increased understanding of their child’s emotional and interactional needs, and accepting the reciprocity of interactional accountability. Discussion: Changes in interactional style enabled participants to alter their perceptions of their own behaviours, their child’s behaviours, and how they influenced one another through interactions. Recommendations for future research and therapeutic practice are discussed in the context of the findings and the existing evidence base

Remembering trauma: Fugard's The Train Driver

Among Fugard's post-apartheid plays one escapes the sentimental nostalgia of his recent turn inwards - The Train Driver (2010). In it he develops a challenging sense of the country's dealings with the past by focusing on the remembering of a 'track suicide' by the white driver, whose tragic story is told by a black gravedigger. The driver's morbidly excessive reaction, the result of identifying with the victim whose grave he seeks, is balanced in performance by the sympathy and acceptance of the gravedigger. The squatter camp cemetery setting provides a liminal urban space stressing the continuity of past wrongs while the selective remembering of the nation's elite masks everyday poverty and violence

A white man in exile: the failure of masculinity in Athol Fugard's Sorrows and Rejoicings

This article explores intersections between understandings of masculinity and nationalism. Etymologically, ‘patriotism’ refers to a love for a fatherland and a patriarchal order; it includes notions of loyalty, honour and a range of qualities often associated with conceptions of masculinity. But if gender remains fixed to these normative constructions, what happens to one’s sense of masculine identity when the national state changes? My interest lies in exploring how white South African men have been repositioned in terms of a shift in their gendered identification, with a reflection on the possibly tragic consequences of maintaining an overly rigid gender role identification. As long as masculinity is embedded within nationalism, it will be caught up within a defensive reactive mode which can turn self-destructive. In order to explore these ideas the article employs as its central metaphor the character of Dawid Olivier, who is the protagonist of Athol Fugard’s Sorrows and Rejoicings (2002)

Visual/verbal-analytic reasoning bias as a function of self-reported autistic like traits

People with autism spectrum condition (ASC) perform well on Raven’s matrices, a test which loads highly on the general factor in intelligence. However, the mechanisms supporting enhanced performance on the test are poorly understood. Evidence is accumulating that milder variants of the ASC phenotype are present in typically developing individuals, and that those who are further along the autistic-like trait spectrum show similar patterns of abilities and impairments as people with clinically diagnosed ASC. We investigated whether self-reported autistic-like traits in a university student sample, assessed using the Autism-Spectrum Quotient (AQ; Baron-Cohen, Wheelwright, Skinner, et al., 2001), predict performance on Raven’s Advanced Progressive Matrices. We found that reporting poorer social skills but better attention switching predicted a higher Advanced matrices score overall. DeShon, Chan, and Weissbein (1995) classified Advanced matrices items as requiring a visuospatial, or a verbal-analytic strategy. We hypothesised that higher AQ scores would predict better performance on visuospatial items than on verbal-analytic items. This prediction was confirmed. These results are consistent with the continuum view and can be explained by the enhanced perceptual functioning theory of performance peaks in ASC. The results also confirm a new prediction about Raven’s Advanced Progressive Matrices performance in people with ASC. </jats:p