Reliability of speech-language pathologists’ categorizations of preschoolers’ communication impairments in practice

Abstract Purpose An efficient and reliable way to categorize children\u27s communication impairments based on routine clinical assessments is needed to inform research and clinical decisions. This preliminary study assessed interrater reliability of speech-language pathologists\u27 categorization of preschoolers\u27 speech, language, and communication impairments using a clinical consensus document. Method Six speech-language pathologists at three community sites worked in pairs to assess 38 children aged 1–5 years, then used the clinical consensus document to categorize children\u27s communication impairments broadly. Identified language and speech sound impairments were further subcategorized. Results Speech-language pathologists had substantial to almost perfect agreement for three broadly focused impairment categories. Agreement for whether language difficulties/disorders were developmental or associated with a biomedical condition was almost perfect, but moderate for whether difficulties impacted receptive or expressive language, or social communication skills. Agreement was fair for rule-based speech delays/disorders, but low for motor-based and mixed speech impairments. Conclusions Results support use of the clinical consensus document to collect data for reliable categories. Additional work is needed to confirm reliability for some broadly focused impairment categories and for subcategorization of speech impairments

Barriers and Facilitators to Implementation of a Preschool Outcome Measure: An Interview Study with Speech-Language Pathologists

Barriers and Facilitators to Implementation of a Preschool Outcome Measure: An Interview Study with Speech-Language Pathologists Abstract Introduction: The Preschool Speech and Language Program in Ontario, Canada implemented the Focus on the Outcomes of Communication Under Six (FOCUS), an outcome measure, in 2012. This study aimed to investigate commonly experienced facilitators of and barriers to implementing the FOCUS in clinical practice from the perspectives of speech-language pathologists (SLPs). Methods: Thirty-seven SLPs participated in semi-structured interviews to share their experiences adopting the FOCUS in clinical practice. A deductive content analysis of interview transcripts was conducted using the Theoretical Domains Framework (TDF), followed by an inductive analysis to identify sub-themes within each domain. Results: SLPs frequently encountered barriers within three TDF domains: Environmental Context and Resources (e.g., difficulties integrating the FOCUS into assessment sessions and intervention schedules), Beliefs about Consequences (e.g., beliefs that data collected using the FOCUS lack relevance to clinical practice), and Social Influences (e.g., administration of the FOCUS harmed rapport with families). Commonly reported facilitators were found in the Behavioural Regulation (e.g., reminder system) and Environmental Context and Resources (e.g., availability of administrative personnel and technology support) domains. Conclusions: SLPs identified barriers and facilitators to implementing an evidence-based outcome measure into practice. Insights drawn from SLPs’ perspectives will support the design of new methods to improve the implementation of functional outcome measurement tools within programs

Usability and Feasibility of a Spoken Language Outcome Monitoring Procedure in a Canadian Early Hearing Detection & Intervention Program: Results of a 1-Year Pilot

Purpose: Best practice recommendations for Early Hearing Detection and Intervention (EHDI) programs include routine spoken language outcome monitoring. The present article reports on pilot data that evaluated the usability and feasibility of a spoken language outcome monitoring procedure developed for Ontario’s Infant Hearing Program (IHP). This procedure included both Program-level monitoring using omnibus language tests from birth to 6 years of age and individual vulnerability monitoring of key domains of spoken language known to be at risk in children who are deaf or hard of hearing. Methodology: Speech-language pathologists (SLPs) in the IHP piloted the new procedures for one year and provided feedback on the procedure through surveys at the end of the pilot. Results: Data was suggestive that the Program-level procedure might be sensitive to change over time and known predictors of spoken language outcomes. Some, but not all, Program-level test scores were predicted by the presence of additional developmental factors. None of the test scores were significantly predicted by severity of hearing loss. Depending on the tests and scores used, some aspects of the Program-level procedure were sensitive to change over time. There was insufficient evidence to support individual vulnerability monitoring. SLPs reported significant concerns about the time involved in implementing both procedures. Conclusions: This article describes preliminary evidence suggesting that the Program-level procedure might be feasible to implement and useful for evaluating EHDI programs. Future evaluations are needed to determine whether the procedure can be accurately implemented to scale in the IHP, and whether the data that results from the procedure can meaningfully inform stakeholders’ decision-making

Families\u27 Experiences in the Virtual Hanen More Than Words Program During the COVID-19 Pandemic

Abstract Purpose: The COVID-19 pandemic required most pediatric rehabilitation programs to shift to a virtual delivery format without the benefits of evidence to support this transition. Our study explored families\u27 experiences participating virtually in More Than Words, a program for parents of autistic children, with the goal of generating new evidence to inform both virtual service delivery and program development. Method: Twenty-one families who recently completed a virtual More Than Words program participated in a semistructured interview. The interviews were transcribed and analyzed in NVivo using a top-down deductive approach that referenced a modified Dynamic Knowledge Transfer Capacity model. Results: Six themes capturing families\u27 experiences with different components of virtual service delivery were identified: (a) experiences participating from home, (b) accessing the More Than Words program, (c) delivery methods and program materials, (d) the speech-language pathologist-caregiver relationship, (e) new skills learned, and (f) virtual program engagement. Conclusions: Most participants had a positive experience in the virtual program. Suggested areas for improvement included the time and length of intervention sessions and increasing social connections with other families. Practice considerations related to the importance of childcare during group sessions and having another adult to support the videorecording of parent-child interactions. Clinical implications include suggestions for how clinicians can create a positive virtual experience for families

QCD and strongly coupled gauge theories : challenges and perspectives

We highlight the progress, current status, and open challenges of QCD-driven physics, in theory and in experiment. We discuss how the strong interaction is intimately connected to a broad sweep of physical problems, in settings ranging from astrophysics and cosmology to strongly coupled, complex systems in particle and condensed-matter physics, as well as to searches for physics beyond the Standard Model. We also discuss how success in describing the strong interaction impacts other fields, and, in turn, how such subjects can impact studies of the strong interaction. In the course of the work we offer a perspective on the many research streams which flow into and out of QCD, as well as a vision for future developments.Peer reviewe