No abstract

Fourteen participants (six females, eight males) ranging in age from 7 years 11 months to 18 years 2 months (mean 11y 7mo) with a confirmed diagnosis of spastic cerebral palsy (CP) were included in the study. Participants included those who drooled (CP+, n=14); age‐ and sex‐matched children with spastic CP who were dry to mild and never to infrequent droolers (CP−, n=14) as well as typically developing peers (CTRL, n=14) served as controls. Frequency of swallowing was measured by using simultaneous cervical ausculation and videotaping of the head and neck. Saliva production was measured with the Saxon test, a simple gauze‐chewing procedure. In addition, Pediatric Evaluation of Disability Inventory (PEDI), Test of Nonverbal Intelligence‐3 (TONI‐3), dysarthria severity scale, and Gross Motor Function Classification System (GMFCS) scores were obtained for each participant. Both groups of participants with CP tended to swallow less frequently than typically developing participants and tended to produce less saliva than typically developing controls; however, these differences were not statistically significant. No correlation was found between amount of saliva produced and amount drooled (r=0.245). An analysis of variance (ANOVA) conducted on the PEDI functional skills mean scores indicated significant differences between the three groups (F((2,39))=23.522, p<0.0001). Likewise, an ANOVA conducted on the TONI‐3 scores revealed statistically significant differences between the three groups (F(2,39)=31.761, p<0.0001). A Spearman's rho correlation indicated that GMFCS scores were not significantly correlated with drooling severity (Spearman's rho correlation=0.3951, p=0.037). Drooling severity was found to be positively correlated with dysarthria severity (Spearman's rho correlation=0.82, p<0.0001). These findings suggest that drooling in patients with CP is related to swallowing difficulties rather than hypersalivation.

Fourteen participants (six females, eight males) ranging in age from 7 years 11 months to 18 years 2 months (mean 11y 7mo) with a confirmed diagnosis of spastic cerebral palsy (CP) were included in the study. Participants included those who drooled (CP+, n=14); age- and sex-matched children with spastic CP who were dry to mild and never to infrequent droolers (CP-, n=14) as well as typically developing peers (CTRL, n=14) served as controls. Frequency of swallowing was measured by using simultaneous cervical ausculation and videotaping of the head and neck. Saliva production was measured with the Saxon test, a simple gauze-chewing procedure. In addition, Pediatric Evaluation of Disability Inventory (PEDI), Test of Nonverbal Intelligence-3 (TONI-3), dysarthria severity scale, and Gross Motor Function Classification System (GMFCS) scores were obtained for each participant. Both groups of participants with CP tended to swallow less frequently than typically developing participants and tended to produce less saliva than typically developing controls; however, these differences were not statistically significant. No correlation was found between amount of saliva produced and amount drooled (r=0.245). An analysis of variance (ANOVA) conducted on the PEDI functional skills mean scores indicated significant differences between the three groups (F(2,39)=23.522,p<0.0001). Likewise, an ANOVA conducted on the TONI-3 scores revealed statistically significant differences between the three groups (F(2,39)=31.761, p<0.0001). A Spearman's rho correlation indicated that GMFCS scores were not significantly correlated with drooling severity (Spearman's rho correlation=0.3951,p=0.037). Drooling severity was found to be positively correlated with dysarthria severity (Spearman's rho correlation=0.82,p<0.0001). These findings suggest that drooling in patients with CP is related to swallowing difficulties rather than hypersalivation.

Considering the needs of siblings is an important component of family-centered practice for children with developmental disabilities. A syntactically and semantically simplified version of the Sibling Need and Involvement Profile (SNIP) was developed to allow self-report. Total profile scores for the self-report version correlated well with the original (Spearman’s rho = .928, p < .01), and test–retest reliability was good (Spearman’s rho = .896, p < .01). Children who piloted the instrument demonstrated good understanding of the vocabulary and the intent of the questions; however, using the instrument with adult supervision is suggested. A comparison of children’s self-report scores to those of their parents’ resulted in low, insignificant correlations, suggesting that parents’ and children’s perspectives do not always agree. Multiple measures, including sibling self-report and parent reports, are necessary for accurate determination of sibling need and involvement.

Augmentative and alternative communication (AAC), the supplementation or replacement of natural speech and/or writing using aided and/or unaided symbols (Lloyd, Fuller, & Arvidson, 1997), can be invaluable in helping children with complex communication needs express themselves in the classroom. However, providing the appropriate piece of technology alone does not ensure successful communication (Douglas, 2012). Rather, the success of a communication interaction between an AAC user and a communication partner will depend heavily on the skills of the communication partner (Kent-Walsh & McNaughton, 2005). Research indicates that training an AAC user's significant communication partners can be of great benefit in "promoting greater participation in daily interactions by people who use AAC systems" (Light, Dattilo, English, Gutierrez, & Hartz, 1992, p. 865). Recent analyses of communication partner-training programs suggest that there is consistent evidence that communication partner instruction not only improves the skills of communication partners but also has a positive impact on the communication of people who use AAC (PWUAAC; Kent-Walsh, Murza, Malani, & Binger, 2015; Shire & Jones, 2015). Furthermore, research suggests that communication partner training can be used effectively as an intervention strategy for individuals using AAC (Kent-Walsh et al., 2015). School-aged children spend roughly 30 hr a week attending school, making school staff members (e.g., therapists, teachers, paraprofessionals) key communication partners in the educational environment. However, many speech-language pathologists (SLPs) and special education teachers "may graduate from preservice training with minimal or no exposure to AAC" (Costigan & Light, 2010, p. 202). In fact, a recent survey conducted of SLPs across the United States found that 74% of respondents felt that they lacked adequate preparation in AAC and assistive technology (Assistive Technology Industry Association, 2012). Therefore, classroom staff are likely to require professional development opportunities to further knowledge and skills in AAC. Unfortunately, traditional training strategies such as inservices are frequently insufficient in helping communication partners develop the expertise they need to support long-term communication needs (Kent-Walsh & McNaughton, 2005). In fact, evaluations of professional development for educators suggest that as few as 10% of participants who attended a single in-service style training implemented what they learned (Showers & Joyce, 1996). "We wouldn't teach someone to drive by giving them a lecture, tossing them a book, and then turning them loose on the freeway. Nonetheless, when we provide traditional staff development in schools, that is pretty much what we do" (Knight, 2007, p. 110).