Describing How School-Based SLPs Determine Eligibility for Children with Speech Sound Disorders

Farquharson, Kelly; Tambyraja, Sherine R.

doi:10.1055/s-0039-1677761

Semin Speech Lang

2019

DOI: 10.1055/s-0039-1677761

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Describing How School-Based SLPs Determine Eligibility for Children with Speech Sound Disorders

Kelly Farquharson

Sherine R. Tambyraja

Abstract: The purpose of this study was to explore how school-based speech–language pathologists (SLPs) determine eligibility for children with speech sound disorders (SSDs). Presently, there is substantial variability nationwide with respect to if or how children with SSDs receive speech therapy in public schools. We report the results of a nation-wide survey of school-based SLPs, which further underscore this variability. Findings provide insight into which and how many factors SLPs report contributing to eligibility … Show more

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Cited by 11 publications

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“…A recent study revealed that only 37.3% of SLPs in Taiwan collected and analyzed connected speech samples in their clinical practice (Chang & Yeh, 2019). Similar results were found in a nationwide survey conducted in the United States; although over 90% of school-based SLPs reported collecting a speech sample as part of their eligibility data, that is, if a child may receive speech therapy services at school (Farquharson & Tambyraja, 2019), only 36% reported always collecting a connected speech sample, whereas 44% of them reported collecting connected speech samples only sometimes (Skahan et al, 2007). In sum, to elicit a more appropriate and representative connected speech sample in SSD assessment requires careful consideration.…”

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confidence: 80%

Comparing the Informativeness of Single-Word Samples and Connected Speech Samples in Assessing Speech Sound Disorders

Yeh

Liu²

2021

J Speech Lang Hear Res

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Purpose Speech-language pathologists (SLPs) are faced with the challenge of quickly and accurately identifying children who present with speech sound disorders (SSD) compared to typically developing (TD) children. The goal of this study was to compare the clinical relevance of two speech sampling methods (single-word vs. connected speech samples) in how sensitive they are in detecting atypical speech sound development in children, and to know whether the information obtained from single-word samples is representative enough of children's overall speech sound performance. Method We compared the speech sound performance of 37 preschool children with SSD ( M age = 4;11 years) and 37 age-sex-matched typically developing children ( M age = 5;0 years) by eliciting their speech in two ways: (a) a picture-naming task to elicit single words, and (b) a story-retelling task to elicit connected speech. Four speech measures were compared across sample type (single words vs. connected speech) and across groups (SSD vs. TD): intelligibility, speech accuracy, phonemic inventory, and phonological patterns. Results Interaction effects were found between sample type and group on several speech sound performance measures. Single-word speech samples were found to differentiate the SSD group from the TD group, and were more sensitive than connected speech samples across various measures. The effect size of single-word samples was consistently higher than connected speech samples for three measures: intelligibility, speech accuracy, and phonemic inventory. The gap in sample type informativeness may be attributed to salience and avoidance effects, given that children tend to avoid producing unfamiliar phonemes in connected speech. The number of phonological patterns produced was the only measure that revealed no gap between two sampling types for both groups. Conclusions On measures of intelligibility, speech accuracy, and phonemic inventory, obtaining a single-word sample proved to be a more informative method of differentiating children with SSD from TD children than connected speech samples. This finding may guide SLPs in their choice of sampling type when they are under time pressure. We discuss how children's performance on the connected speech sample may be biased by salience and avoidance effects and/or task design, and may, therefore, not necessarily reveal a poorer performance than single-word samples, particularly in intelligibility, speech accuracy, and the number of phonological patterns, if these task limitations are circumvented. Our findings show that the performance gap, typically observed between the two sampling types, largely depends on which performance measures are evaluated with the speech sample. Our study is the first to address sampling type differences in SSD versus TD children and has significant clinical implications for SLPs looking for sampling types and measures that reliably identify SSD in preschool-aged children.

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supporting

confidence: 80%

Comparing the Informativeness of Single-Word Samples and Connected Speech Samples in Assessing Speech Sound Disorders

Yeh

Liu²

2021

J Speech Lang Hear Res

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Baseline Stimulability Predicts Patterns of Response to Traditional and Ultrasound Biofeedback Treatment for Residual Speech Sound Disorder

McAllister

Eads

Kabakoff

et al. 2022

J Speech Lang Hear Res

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Purpose: This study aimed to identify predictors of response to treatment for residual speech sound disorder (RSSD) affecting English rhotics. Progress was tracked during an initial phase of traditional motor-based treatment and a longer phase of treatment incorporating ultrasound biofeedback. Based on previous literature, we focused on baseline stimulability and sensory acuity as predictors of interest. Method: Thirty-three individuals aged 9–15 years with residual distortions of /ɹ/ received a course of individual intervention comprising 1 week of intensive traditional treatment and 9 weeks of ultrasound biofeedback treatment. Stimulability for /ɹ/ was probed prior to treatment, after the traditional treatment phase, and after the end of all treatment. Accuracy of /ɹ/ production in each probe was assessed with an acoustic measure: normalized third formant (F3)–second formant (F2) distance. Model-based clustering analysis was applied to these acoustic measures to identify different average trajectories of progress over the course of treatment. The resulting clusters were compared with respect to acuity in auditory and somatosensory domains. Results: All but four individuals were judged to exhibit a clinically significant response to the combined course of treatment. Two major clusters were identified. The “low stimulability” cluster was characterized by very low accuracy at baseline, minimal response to traditional treatment, and strong response to ultrasound biofeedback. The “high stimulability” group was more accurate at baseline and made significant gains in both traditional and ultrasound biofeedback phases of treatment. The clusters did not differ with respect to sensory acuity. Conclusions: This research accords with clinical intuition in finding that individuals who are more stimulable at baseline are more likely to respond to traditional intervention, whereas less stimulable individuals may derive greater relative benefit from biofeedback. Supplemental Material: https://doi.org/10.23641/asha.20422236

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Clinicians' Perspectives of Treatment for Lateralization Errors: A Quantitative and Qualitative Study

Overby

Mazeika

DiFazio

et al. 2022

LSHSS

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Purpose: This mixed-methods study aimed to obtain information regarding speech-language pathologists' (SLPs) perspectives about treatment of lateralization errors (LEs), challenges to implementing evidence-based LE treatment practice, and the sources SLPs' use to find evidence to treat LEs. This information can assist our understanding of ways to facilitate the uptake of evidence-based practice into the everyday treatment of clients with this disorder. Method: A convergent parallel mixed-methods design was used to collect data from SLPs ( N = 214) using 24 questions from an online survey distributed through electronic mailing lists and Speech and Hearing State Associations. Quantitative data were analyzed using frequencies and averages; themes and subthemes of qualitative data were analyzed using a content analysis approach with no a priori codes. Quantitative and qualitative results were compared and integrated. Results: Participants believed that LEs required individualized treatment before the age of 5 years, were largely caused by structural and neuromuscular factors, and required an understanding of orofacial and dental structure and function. Challenges to implementing LE treatment included a lack of skills and knowledge specific to LEs, competing demands on clinicians' time and resources, and a research–practice gap. Sources of evidence frequently used to obtain information about LE treatment were colleagues, trainings, workshops, and American Speech-Language-Hearing Association journals. Conclusions: Clinicians believe that LE treatment is challenging and requires skill training. Future research in LEs will need to consider the real-world decisions clinicians must make when treating this disorder as well as clinicians' everyday constraints and challenges.

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Describing How School-Based SLPs Determine Eligibility for Children with Speech Sound Disorders

Cited by 11 publications

References 22 publications

Comparing the Informativeness of Single-Word Samples and Connected Speech Samples in Assessing Speech Sound Disorders

Comparing the Informativeness of Single-Word Samples and Connected Speech Samples in Assessing Speech Sound Disorders

Baseline Stimulability Predicts Patterns of Response to Traditional and Ultrasound Biofeedback Treatment for Residual Speech Sound Disorder

Clinicians' Perspectives of Treatment for Lateralization Errors: A Quantitative and Qualitative Study

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