What do parents think about their involvement in speech-language pathology intervention? A Qualitative Critically Appraised Topic

A critically appraised topic (CAT) is one form of rapid review that can be particularly useful for informing practice. The purpose of this CAT was to determine what caregivers of preschool-aged children with speech, language or communication disorders (2–5 years of age) think of their involvement in speech-language pathology intervention in community-based settings. In addition to this CAT, the authors present and discuss a methodology for qualitative critically appraised topics (this issue). The authors propose an update to this CAT in June 2021

Evidence-based Reasoning Processes in Education: A Model to Support Interventionist Practice.

The Evidence-based Reasoning model is a systematic inquiry into student learning to determine what interventions are required in classroom contexts. The four step process includes noticing students who need additional support in their learning, the use of assessment data to establish an evidence-base, and subsequent interpretation that leads to decision making. The reasoning process is supported by collaborative practice models both within and beyond the teaching profession. The evaluation of interventions is integral in determining the impact that interventions have on student learning

The qual-CAT: applying a rapid review approach to qualitative research to support clinical decision-making in speech-language pathology practice

Systematic reviews and meta-syntheses of qualitative research produce ‘a sum greater than its parts’. Qualitative findings are examined alongside one another, and new insights are discovered about the topic under consideration. However, a barrier to clinicians undertaking these reviews is the time and knowledge required. Rapid review approaches, such as the Critically Appraised Topic (CAT), have recently been promoted in speech-language pathology, encouraging strategic, clinically driven examination of key research in focused topic areas, with the aim of supporting clinical decision-making. A strength of the CAT approach is that it supports interpretation and use of evidence by people who are not experts in the methodologies used. Additionally, CATs reduce the time input required by focusing on the best evidence available, and take a pragmatic approach to analysis across studies. While CAT methodologies have been detailed in relation to quantitative research, qualitative CAT methodologies have not specifically been discussed. Searching, ranking of research strength, appraisal and analysis methods are all likely to vary for qualitative CATs. This paper proposes and details a methodology for a “qual-CAT” approach, providing examples and steps that support the use of this methodology in practice

Best practice in working with children who have developmental language disorder: a focused review of the current research evidence base

The purpose of this paper is to provide a synthesis of the current international research evidence base regarding best practice in the diagnosis and treatment of children with language disorders. We begin with a discussion about the terminology used and how this relates to identification and diagnosis, and then describe assessment and treatment practices. The discussion of intervention and case management of these children focuses on the use of high quality evidence that presents an overview of treatment approaches, rather than specific treatment programmes that may not be relevant to all international practice settings. The paper sets the context of the wider international research evidence base: we also include commentary that may be more relevant to some countries across mainland Europe, and specifically to the Czech Republic context. Research studies that reflect local languages and culture are a highly important component of the evidence base for practice, but these should be considered in the context of international consensus evidence. In particular, some strategic recommendations are made to address the inherent challenges of sustaining best practice where open access to evidence sources may be constrained

Improving outcomes of preschool language delay in the community: protocol for the Language for Learning randomised controlled trial

BackgroundEarly language delay is a high-prevalence condition of concern to parents and professionals. It may result in lifelong deficits not only in language function, but also in social, emotional/behavioural, academic and economic well-being. Such delays can lead to considerable costs to the individual, the family and to society more widely. The Language for Learning trial tests a population-based intervention in 4 year olds with measured language delay, to determine (1) if it improves language and associated outcomes at ages 5 and 6 years and (2) its cost-effectiveness for families and the health care system. Methods/DesignA large-scale randomised trial of a year-long intervention targeting preschoolers with language delay, nested within a well-documented, prospective, population-based cohort of 1464 children in Melbourne, Australia. All children received a 1.25-1.5 hour formal language assessment at their 4th birthday. The 200 children with expressive and/or receptive language scores more than 1.25 standard deviations below the mean were randomised into intervention or &lsquo;usual care&rsquo; control arms. The 20-session intervention program comprises 18 one-hour home-based therapeutic sessions in three 6-week blocks, an outcome assessment, and a final feed-back/forward planning session. The therapy utilises a &lsquo;step up-step down&rsquo; therapeutic approach depending on the child&rsquo;s language profile, severity and progress, with standardised, manualised activities covering the four language development domains of: vocabulary and grammar; narrative skills; comprehension monitoring; and phonological awareness/pre-literacy skills. Blinded follow-up assessments at ages 5 and 6 years measure the primary outcome of receptive and expressive language, and secondary outcomes of vocabulary, narrative, and phonological skills. DiscussionA key strength of this robust study is the implementation of a therapeutic framework that provides a standardised yet tailored approach for each child, with a focus on specific language domains known to be associated with later language and literacy. The trial responds to identified evidence gaps, has outcomes of direct relevance to families and the community, includes a well-developed economic analysis, and has the potential to improve long-term consequences of early language delay within a public health framework.<br /

Speaking of online learning: Alternative practice-based learning experiences for speech pathologists in Australia, Ghana and Hong Kong

Speech Pathology programs usually send students to workplaces to learn clinical skills necessary for practice. During COVID-19, programs needed to respond quickly to ensure that students continued to gain the necessary experiences and skills required to progress through their program and graduate as clinicians, while simultaneously complying with COVID-19 requirements. Case studies from seven different universities in Australia, Ghana and Hong Kong described the diverse ways in which placements were adapted to be COVID-safe, taking into account local needs. Some practices which had been included in placement education prior to the pandemic, such as telepractice and simulation-based learning, were extended and developed during this time. Educators, students, clinicians and clients responded to the rapidly changing needs of the time with flexibility and innovation, utilising a variety of technologies and tools to support case-based and virtual learning opportunities. Feedback from these diverse stakeholders about the experiences was positive, despite inevitable limitations and less-than-ideal circumstances. The positive findings provided insights for consideration in the future: could strategies implemented in response to the pandemic continue to be incorporated into placement experiences, enhancing current practices and maintaining student performance outcomes? Exceptional circumstances prompted exceptional responses; flexibility and innovation were accelerated in response to the pandemic and may transform future placement-based learning opportunities

Speaking of Online Learning: Alternative Practice-Based Learning Experiences for Speech Pathologists in Australia, Ghana and Hong Kong

Speech Pathology programs usually send students to workplaces to learn clinical skills necessary for practice. During COVID-19, programs needed to respond quickly to ensure that students continued to gain the necessary experiences and skills required to progress through their program and graduate as clinicians, while simultaneously complying with COVID-19 requirements. Case studies from seven different universities in Australia, Ghana and Hong Kong described the diverse ways in which placements were adapted to be COVID-safe, taking into account local needs. Some practices which had been included in placement education prior to the pandemic, such as telepractice and simulation-based learning, were extended and developed during this time. Educators, students, clinicians and clients responded to the rapidly changing needs of the time with flexibility and innovation, utilising a variety of technologies and tools to support case-based and virtual learning opportunities. Feedback from these diverse stakeholders about the experiences was positive, despite inevitable limitations and less-than-ideal circumstances.  The positive findings provided insights for consideration in the future: could strategies implemented in response to the pandemic continue to be incorporated into placement experiences, enhancing current practices and maintaining student performance outcomes? Exceptional circumstances prompted exceptional responses; flexibility and innovation were accelerated in response to the pandemic and may transform future placement-based learning opportunities

Evidence-based reasoning processes in education: A model to support interventionist practice

The Evidence-based Reasoning model is a systematic inquiry into student learning to determine what interventions are required in classroom contexts. The four step process includes noticing students who need additional support in their learning, the use of assessment data to establish an evidence-base, and subsequent interpretation that leads to decision making. The reasoning process is supported by collaborative practice models both within and beyond the teaching profession. The evaluation of interventions is integral in determining the impact that interventions have on student learning