Caroline Bowen

Parents and children together (PACT): a collaborative approach to phonological therapy

Developmental phonological disorders are a group of developmental languagelearning disorders of unknown aetiology, occurring at a phonological level, andmanifested in the use of abnormal speech patterns, by children, impairing theirgeneral intelligibility. This is one of a series of papers arising from an e

The role of families in optimizing phonological therapy outcomes

Developed in Australia, Parents and Children Together (PACT) is a broad-based, family-centred phonological therapy. It is a treatment approach for developmental phonological disorders in the course of whose implementation speech and language therapists enlist the active participation of parents and significant others. It requires family members to learn technical information and develop novel skills to use, with professional guidance, in relation to their own child and his or her specific speech clarity issues. In this paper we review the family education and “homework’ aspects of PACT and explore, with brief case illustrations, the participation of 13 families involved in its administration.

A tested phonological therapy in practice

The focus here is a detailed case description of a broad-based model for treat ing developmental phonological disorders. Successful treatment comprising 27 consultations over 17 months, of a girl aged 4;4 at the outset, with a mod erate phonological disability, is examined in detail. The model’s strength is in its combination of family education, metalinguistic tasks, phonetic produc tion procedures, multiple exemplar techniques and homework. Treatment is administered in planned alternating therapy blocks and breaks from therapy attendance.

International aspirations for speech-language pathologists' practice with multilingual children with speech sound disorders: Development of a position paper

UNLABELLEDnA major challenge for the speech-language pathology profession in many cultures is to address the mismatch between the linguistic homogeneity of the speech-language pathology profession and the linguistic diversity of its clientele (Caesar & Kohler, 2007, p. 198). This paper outlines the development of the Multilingual Children with Speech Sound Disorders: Position Paper created to guide speech-language pathologists (SLPs) facilitation of multilingual childrens speech. An international expert panel was assembled comprising 57 researchers (SLPs, linguists, phoneticians, and speech scientists) with knowledge about multilingual childrens speech, or children with speech sound disorders. Combined, they had worked in 33 countries and used 26 languages in professional practice. Fourteen panel members met for a one-day workshop to identify key points for inclusion in the position paper. Subsequently, 42 additional panel members participated online to contribute to drafts of the position paper. A thematic analysis was undertaken of the major areas of discussion using two data sources: (a) face-to-face workshop transcript (133 pages) and (b) online discussion artifacts (104 pages). Finally, a moderator with international expertise in working with children with speech sound disorders facilitated the incorporation of the panels recommendations. The following themes were identified: definitions, scope, framework, evidence, challenges, practices, and consideration of a multilingual audience. The resulting position paper contains guidelines for providing services to multilingual children with speech sound disorders (http://www.csu.edu.au/research/multilingual-speech/position-paper). The paper is structured using the International Classification of Functioning, Disability and Health: Children and Youth Version (World Health Organization, 2007) and incorporates recommendations for (a) children and families, (b) SLPs assessment and intervention, (c) SLPs professional practice, and (d) SLPs collaboration with other professionals.nnnLEARNING OUTCOMESnReaders will 1. recognize that multilingual children with speech sound disorders have both similar and different needs to monolingual children when working with speech-language pathologists. 2. Describe the challenges for speech-language pathologists who work with multilingual children. 3. Recall the importance of cultural competence for speech-language pathologists. 4. Identify methods for international collaboration and consultation. 5. Recognize the importance of engaging with families and people within their local communities for supporting multilingual children in context.

PACT: Parents and children together in phonological therapy

PACT (parents and children together) is a broad-based intervention approach for children with phonological impairment, which involves the participation of caregivers in therapy. Its components are: Parent Education; Metalinguistic Training; Phonetic Production Training; Multiple Exemplar Training (minimal pair therapy and auditory bombardment); and Homework. Accommodating to the gradual nature of phonological change in typical development, PACT therapy is delivered in planned therapy blocks and breaks from therapy attendance, during which parents continue aspects of the therapy. A review of literature relevant to the theoretical underpinning, development and evaluation of PACT is provided, and unique features of the approach are highlighted. The processes of speech assessment using parent-observed screening, independent and relational analyses, treatment planning and scheduling, and target selection and goal-setting are presented and discussed in the context of Jarrod, a 7 year old boy with a severe, inconsistent phonological impairment. Difficulties in applying the PACT approach with Jarrod are noted, principally that PACT is most suited to the three to six year age-group. Alternative intervention approaches are suggested.

A phonological therapy in depth: a reply to commentaries

In conclusion, the model itself is theoretically sound and the results of the eY cacy study are encouraging. Future research might usefully be directed at invest igating the relative importance of each of the aspects of the model, the eY cacy of the planned breaks and the eVects of parent education and involvement in therapy. The model oVers a broad outline to aid clin icians in planning eVect ive therapy programmes. The emphasis of approach will be based on the detailed analysis of each child’s phonological system and articulatory skills and therapy tasks can be drawn in from several diVerent resources.

A Call for Evidence to Inform the Use of Twitter in Speech Language Pathology

Background: Twitter is a social networking micro-blogging site that is used increasingly in a range of health disciplines to exchange information. Publicly available Twitter data show that some speech-language pathologists (SLPs) are using Twitter for multiple professional purposes. To date, there is little in the research literature that might guide SLPs in the use of Twitter for (1) local, national, and global SLP networking, (2) professional development, (3) public health interventions or awareness campaigns, or (4) engagement with hard to reach populations or any other specific clinical population or client group. Aims: To review the peer-reviewed literature for evidence on how SLPs use Twitter for any aspects of their work, to inform future research and guide SLP practice in the use of Twitter. Method: On 30th April 2014, we searched four scientific databases: CINAHL, PsycINFO, Medline, and Web of Science, for journal publications in English on the use of Twitter in the field of speech-language pathology. Search terms relating to Twitter, combined with speech-language pathology discipline labels, were employed. Results: This paper provides results of the search and a summary of literature on the use of Twitter by SLPs. Using a broad range of search terms in the four databases, we found only two peerreviewed papers, respectively describing a research protocol for investigating the use of Twitter by people with a communication disability, and the use of Twitter for professional learning communities in speech-language pathology; and three non-peer reviewed publications. Results are discussed in the context of evidence of how Twitter is used in other health disciplines and directions for future research are proposed. Conclusion: In the absence of peer-reviewed evidence guiding its strategic use, and in the context of Twitter enabling instant worldwide publication online, we contend that an ad-hoc approach to the use of Twitter could result in shortcomings in its use by SLPs. We argue that SLPs, including those engaged in teaching, learning, research, and clinical practice: (1) considering the use of Twitter to engage with and support colleagues; (2) knowing about and work within its inherent limitations, in order to engage with the general public and interested parties on matters pertinent and relevant to the discipline; and (3) monitoring the impacts and evaluate outcomes from Twitter initiatives in the field of SLP so as to add to the evidence-base guiding social media practice.

Phonological processes in the speech of school-age children with hearing loss: Comparisons with children with normal hearing

PURPOSEnIn this descriptive study, phonological processes were examined in the speech of children aged 5;0-7;6 (years; months) with mild to profound hearing loss using hearing aids (HAs) and cochlear implants (CIs), in comparison to their peers. A second aim was to compare phonological processes of HA and CI users.nnnMETHODnChildren with hearing loss (CWHL, Nu202f=u202f25) were compared to children with normal hearing (CWNH, Nu202f=u202f30) with similar age, gender, linguistic, and socioeconomic backgrounds. Speech samples obtained from a list of 88 words, derived from three standardized speech tests, were analyzed using the CASALA (Computer Aided Speech and Language Analysis) program to evaluate participants phonological systems, based on lax (a process appeared at least twice in the speech of at least two children) and strict (a process appeared at least five times in the speech of at least two children) counting criteria.nnnRESULTSnDevelopmental phonological processes were eliminated in the speech of younger and older CWNH while eleven developmental phonological processes persisted in the speech of both age groups of CWHL. CWHL showed a similar trend of age of elimination to CWNH, but at a slower rate. Children with HAs and CIs produced similar phonological processes. Final consonant deletion, weak syllable deletion, backing, and glottal replacement were present in the speech of HA users, affecting their overall speech intelligibility.nnnCONCLUSIONSnDevelopmental and non-developmental phonological processes persist in the speech of children with mild to profound hearing loss compared to their peers with typical hearing. The findings indicate that it is important for clinicians to consider phonological assessment in pre-school CWHL and the use of evidence-based speech therapy in order to reduce non-developmental and non-age-appropriate developmental processes, thereby enhancing their speech intelligibility.