Collaborative working between speech and language therapists and teaching staff in mainstream UK primary schools: A scoping review

Support for school-age children with speech, language and communication needs (SLCN) usually takes place within the school setting. Successful outcomes for children with SLCN rely on effective collaborative working between speech and language therapists (SLTs), school staff and families. We need to understand the current evidence regarding the joint working practices, relationships and collaboration experiences of SLT and teaching staff within mainstream primary schools, in order to identify whether sufficient research exists for a systematic review within this field, and to inform practice. The purpose of this scoping review was to identify what research currently exists regarding collaboration, roles and relationships of SLTs and teaching staff within mainstream UK primary schools, and clarify the nature, participants and concepts described within this literature. A scoping review framework was used, consisting of identification of the review objectives, identification of relevant studies, study selection and iterative searches, data charting and reporting of the results. Information regarding research question, participants, data collection and analysis and terms used for key concepts was extracted. This scoping review identified 14 papers, however, collaboration was the primary focus of only 5 of these. Clarity and perceptions of roles were key themes within six of the papers. Whilst facilitators and barriers to collaboration are discussed in all 14 papers, only 4 studies aimed to investigate barriers and facilitators. Teaching assistant (TA) views are underrepresented within the research. Drawing conclusions from the body of research is challenging due to the varied ways in which the key concept ‘collaboration’ is used. Currently, there is insufficient literature to carry out a systematic review. This scoping review highlights the need for research that considers collaboration within the complex social network of school staff (including TAs) and SLTs, in order to ensure that future guidance is rooted in research

Early identification of children at risk of communication disorders: Introducing a novel battery of Dynamic Assessments for infants

Purpose Many children with communication disorders (CD) experience lengthy gaps between parental reporting of concerns and formal identification by professionals. This means that children with CD are denied access to early interventions that may help to support the development of communication skills and prevent possible negative sequelae associated with long-term outcomes. This may be due, in part, to the lack of assessment instruments available for children younger than three years of age. This study therefore reports on promising preliminary data from a novel set of valid dynamic assessment measures designed for infants. Methods We recruited 53 low-risk children and two groups of children considered to be at high risk for CD (n=17 social-high-risk and n=22 language high-risk) due to family members with language and social communication difficulties. Children were between 1 and 2 years of age and were assessed using a battery of five dynamic assessment (DA) tasks related to receptive vocabulary, motor imitation, response to joint attention, turn taking and social requesting. A set of standardised measures was also used. Results The DA tasks showed high levels of inter-rater reliability and relationships with age across a cross-sectional sample of children from the low-risk group. Three tasks showed moderate to strong correlations with standardised measures taken at the same age, with particularly strong correlations between the DA of receptive vocabulary and other receptive language measures. The DA of receptive vocabulary was also the only task to discriminate between the three risk groups, with the social-high-risk group scoring lower. Conclusions These results provide preliminary information about early DA tasks, forming the basis for further research into their utility. DA tasks might eventually facilitate the development of new methods for detecting CD in very young children, allowing earlier intervention and support

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The importance and challenges of improving early identification of language abilities: a commentary on Gasparini et al. (2023)

Finding early predictors of later language skills and difficulties is fraught with challenges because of the wide developmental variation in language. Gasparini et al. (Journal of Child Psychology and Psychiatry, 2023) aimed to address this issue by applying machine learning methods to parent reports taken from a large longitudinal database (Early Language in Victoria Study). Using this approach, they identify two short, straightforward item sets, taken at 24 and 36 months, that can adequately predict language difficulties when children are 11 years of age. Their work represents an exciting step towards earlier recognition and support for children with Developmental Language Disorder. This commentary highlights the advantages and challenges of identifying early predictors of language in this way, and discusses future directions that can build on this important contribution

Assessing 'coherence' in the spoken narrative accounts of autistic people: A systematic scoping review

Background: The ability to produce a well-structured, coherent narrative account is essential for successful everyday communication. Research suggests that autistic people may find this challenging, and that narrative assessment can reveal pragmatic difficulties in this population that are missed on sentence-level tasks. Previous studies have used different methodologies to assess spoken narrative skills in autism. This review systematically examined these approaches and considered their utility for assessing narrative coherence. Method: Keyword database searches were conducted, with records screened by two independent reviewers. Eligible studies (n= 59) included specified frameworks for evaluating structure/coherence in spoken narrative accounts by autistic participants of any age. Studies were categorised according to the type of narrative scoring scheme used, and strengths and limitations were considered. Results: Over 80% of included articles reported observational cross-sectional studies, with participants generally matched on age and cognitive ability with non-autistic comparison groups. The most common approaches involved coding key elements of narrative structure (‘story grammar’) or scoring the inclusion of pre-determined ‘main events’. Alternative frameworks included ‘holistic’ rating scales and subjective quality judgements by listeners. Some studies focused specifically on ‘coherence’, measuring diverse aspects such as causal connectedness and incongruence. Scoring criteria varied for each type of framework. Conclusions: Findings indicated that solely assessing story structure ignores important features contributing to the coherence of spoken narrative accounts. Recommendations are that future research consider the following elements: (1) context, (2) chronology, (3) causality, (4) congruence, (5) characters (cognition/emotion), and (6) cohesion; and scoring methods should include rating scales to obtain sufficiently detailed information about narrative quality

Application of tissue Doppler to interpretation of Dobutamine echocardiography and comparison with quantitative coronary angiography

The main limitation of dobutamine echocardiography (DE) is its subjective interpretation. We sought to reduce the need for expert interpretation by developing a quantitative approach to DE using myocardial Doppler velocity (MDV) in 242 patients undergoing DE. In 128 patients with a normal dobutamine echocardiogram, the normal range was designed to give a specificity of 80%. The accuracy of this range was investigated in 114 consecutive patients who underwent coronary angiography within 2 months of DE. A standard dobutamine echocardiographic protocol was used, with MDV gathered from color tissue Doppler at rest and peak stress; Wall motion at these stages was scored by experienced observers using a 16-segment model and MDV was measured off-line. Sensitivity and specificity of wall motion scoring and MDV were obtained by comparison with angiographic evidence of disease, defined as stenosis >50% of the coronary artery diameter. The normal range in tethered segments (septum, anteroseptum, and inferior) was greater than or equal to7 cm/s in the basal segments and greater than or equal to5 cm/s in the midsegments. In the free wall (anterior, lateral, and posterior), the cutoff was greater than or equal to6 cm/s in the base and greater than or equal to4 cm/s in the midventricle. Of 114 patients undergoing angiography, 84 (75%) had significant stenoses, and the sensitivity of wall motion scoring and MDV were 88% and 83%, respectively, with specificities of 81% and 72% (p = NS). The accuracy was similar overall (86% vs 80%), as well as in each vascular territory. These data suggest that a fully quantitative interpretation of DE using site-specific normal ranges of tissue Doppler, which account for regional variations of base-apex function, is feasible and equivalent in accuracy to expert wall motion scoring. (C) 2001 by Excerpta Medica, Inc