Pamela Snow

Measuring perception of communicative ability: the development and evaluation of the La Trobe communication questionnaire

The La Trobe communication questionnaire (LCQ) was designed to measure perceived communicative ability. It was developed to enable collection of information from various sources including the self-perceptions of individuals as well as the perceptions of close others. In this paper we report the development of the questionnaire, its psychometric properties and normative data for the perceptions of young adults and the comparative perceptions of their close others. Participants in the study were 256 adults comprising 147 primary subjects and 109 close others. Primary subjects ranged in age from 16-39 years with a mean age of 20.6 years. The 30 item questionnaire was structured using a modified Likert-type scale with four possible levels of response: (1) never or rarely; (2) sometimes; (3) often; and (4) usually or always. Internal consistency was high (Cronbachs alpha = 0.8596) and good stability over time for self-report was demonstrated (r = 0.7558). There was a significant difference (p < 0.0001) between the perceptions of primary subjects and close others with primary subjects perceiving themselves to have more frequent communication difficulties, than did their close others. Overall, our findings suggest that the LCQ is a promising means of measuring perceived communicative ability in young adults.

Guide to questioning children during the free-narrative phase of an investigative interview

Abstract The inability of professionals to maintain the use of open-ended questions in the free-narrative phase of investigative interviews with children has been a major problem around the globe. The current paper addresses this concern by describing the key principles underlying the elicitation of free-narrative accounts and practical suggestions for formulating questions. The paper focuses on interviewing children in the early- and middle-childhood years and commences with a definition of the term “free-narrative account” and a description of how such accounts typically develop in children. A description is then provided of the four key characteristics of a good question in the free-narrative interview phase. These include (a) simple language, (b) absence of specific details or coercive techniques, (c) flexibility on the part of the interviewee to choose what details will be reported, and (d) encouragement of an elaborate response. Finally, the process of eliciting a narrative account is briefly described, including examples of questions that adhere to the four characteristics listed above.

The Effects of Clinical Pathways on Professional Practice, Patient Outcomes, Length of Stay, and Hospital Costs: Cochrane Systematic Review and Meta-Analysis

This paper is a summary version of the previously published Cochrane review. It may increase the reach of the topic to health researchers and practitioners and encourage further discussion. The systematic review aims to summarize the evidence and assess the effect of clinical pathways on professional practice, patient outcomes, length of hospital stay, and hospital costs. The authors searched the Database of Abstracts of Reviews of Effectiveness, the Effective Practice and Organisation of Care Register, the Cochrane Central Register of Controlled Trials and bibliographic databases including MEDLINE, EMBASE, CINAHL, NHS EED, and Global Health. Twenty-seven studies considering a total of 11,398 participants were included for analysis. The main results were a reduction in in-hospital complications (odds ratio 0.58: 95% CI [0.36, 0.94] and improved documentation (odds ratio 11.95: 95% CI [4.72, 30.30]) associated with clinical pathways. Considerable variation in study design and settings prevented statistical pooling of results for length of stay (LOS) and hospital costs. The authors concluded that clinical pathways are associated with reduced in-hospital complications and improved documentation.

Principles That Underpin Effective School-Based Drug Education.

This study identifies the conceptual underpinnings of effective school-based drug education practice in light of contemporary research evidence and the practical experience of a broad range of drug education stakeholders. The research involved a review of the literature, a national survey of 210 Australian teachers and others involved in drug education, and structured interviews with 22 key Australian drug education policy stakeholders. The findings from this research have been distilled and presented as a list of 16 principles that underpin effective drug education. In broad terms, drug education should be evidence-based, developmentally appropriate, sequential, and contextual. Programs should be initiated before drug use commences. Strategies should be linked to goals and should incorporate harm minimization. Teaching should be interactive and use peer leaders. The role of the classroom teacher is central. Certain program content is important, as is social and resistance skills training. Community values, the social context of use, and the nature of drug harm have to be addressed. Coverage needs to be adequate and supported by follow-up. It is envisaged that these principles will provide all those involved in the drug education field with a set of up-to-date, research-based guidelines against which to reference decisions on program design, selection, implementation, and evaluation.

Child speech, language and communication need re-examined in a public health context: a new direction for the speech and language therapy profession

BACKGROUND Historically speech and language therapy services for children have been framed within a rehabilitative framework with explicit assumptions made about providing therapy to individuals. While this is clearly important in many cases, we argue that this model needs revisiting for a number of reasons. First, our understanding of the nature of disability, and therefore communication disabilities, has changed over the past century. Second, there is an increasing understanding of the impact that the social gradient has on early communication difficulties. Finally, understanding how these factors interact with one other and have an impact across the life course remains poorly understood. AIMS To describe the public health paradigm and explore its implications for speech and language therapy with children. METHODS & PROCEDURES We test the application of public health methodologies to speech and language therapy services by looking at four dimensions of service delivery: (1) the uptake of services and whether those children who need services receive them; (2) the development of universal prevention services in relation to social disadvantage; (3) the risk of over-interpreting co-morbidity from clinical samples; and (4) the overlap between communicative competence and mental health. OUTCOMES & CONCLUSIONS It is concluded that there is a strong case for speech and language therapy services to be reconceptualized to respond to the needs of the whole population and according to socially determined needs, focusing on primary prevention. This is not to disregard individual need, but to highlight the needs of the population as a whole. Although the socio-political context is different between countries, we maintain that this is relevant wherever speech and language therapists have a responsibility for covering whole populations. Finally, we recommend that speech and language therapy services be conceptualized within the framework laid down in The Ottawa Charter for Health Promotion.

Measuring Perceived Communicative Ability After Traumatic Brain Injury: Reliability and Validity of the La Trobe Communication Questionnaire*

ObjectiveFurther psychometric evaluation of a measure designed to assess communication ability after traumatic brain injury (TBI). DesignInternal consistency, test-retest reliability, and validity for self-report and close-other versions of the tool were evaluated. ParticipantsEighty-eight adults with severe TBI (mean posttraumatic amnesia 53.12 days) and 71 close others (relatives or friends). MeasureThe La Trobe Communication Questionnaire (LCQ), a 30-item questionnaire that measures cognitive-communication ability from multiple perspectives. ResultsInternal consistency coefficients were above 0.9 and test-retest reliability exceeded 0.80. The questionnaire was sensitive to the effect of severity of injury. ConclusionThe La Trobe Communication Questionnaire is a promising tool for measuring perceived communication ability in adults with severe TBI.

Oral language competence in incarcerated young offenders: Links with offending severity

Previous research in Australia and overseas has shown that young offenders serving community-based orders are at high-risk for undetected but clinically significant oral language difficulties. However, this phenomenon has received little attention in incarcerated samples, and links with offending severity, mental health, and other markers of early risk have not previously been systemically examined. A cross-sectional examination of 100 young offenders (mean age 19.03 years) completing custodial sentences in Victoria, Australia was conducted. A range of standardized oral language, IQ, mental health, and offending severity measures was employed. Forty-six per cent of participants were classified as language impaired (LI), and these were compared with the non-LI sub-group on background and offending variables. When the sub-group with high scores on a measure of offending severity was compared with those with (relatively) lower offending scores, significant differences on a range of language measures were identified. A range of early risk indicators (such as placement in Out of Home Care) was also examined with respect to language impairment in this high-risk group. Results are discussed with respect to policy and practice pertaining to early intervention for vulnerable children, and implications for service delivery within the justice system. In particular, emphasis is placed on the need to closely examine the oral language skills of children who struggle with the transition to literacy and then display behavioural difficulties in the classroom. Once a young person is engaged with youth justice services, a high index of suspicion should be maintained with respect to their oral language skills; for example, in relation to forensic interviewing and the ability to benefit from verbally mediated interventions.

What's the story? An exploration of narrative language abilities in male juvenile offenders

Abstract This paper is concerned with the narrative language (story telling) abilities of a group of juvenile offenders completing community-based court orders in Melbourne, Australia. A convenience sample of 30 male young offenders was compared with 50 male non-offenders attending government high schools in the same region of Melbourne. Participants provided an audiotaped description of a six-frame cartoon (the “Flowerpot Incident”). Samples were transcribed and subjected to story grammar analysis, to examine differences between groups regarding both structural and qualitative adequacy. Young offenders produced narratives which were significantly poorer than those of controls with respect to the presence and adequacy of the seven story grammar elements described by Stein and Glenn (In R. O. Freedle (Ed.), New Directions in Discourse Processing (pp. 53–120) 1979). Findings are discussed in relation to implications for investigative and evidentiary interviewing.

Discourse asssessment following traumatic brain injury: A pilot study examining some demographic and methodological issues

Abstract With the shift away from evaluation of isolated aspects of linguistic performance, discourse assessment has become an important tool in assessing the communication skills of individuals who have sustained traumatic brain injury (TBI). Given the substantial evidence that the brain-injured represent a largely preselected population, it would seem relevant that speech pathologists acquire a greater understanding of the role of premorbid sociolinguistic and demographic characteristics in determining the clinical presentation of these patients. This demands that close consideration be given to the selection of control subjects for research with this population. Further, there needs to be clarification about which discourse tasks (by virtue of their cognitive/linguistic demands) are sensitive to brain injury. The pilot study described here compared the discourse skills of three TBI subjects with those of three non-TBI orthopaedic patients, on a range of discourse tasks thought to make differing cogniti...

Child maltreatment, mental health and oral language competence: Inviting speech-language pathology to the prevention table*

Child maltreatment (neglect and abuse of various forms) is a serious global issue. Although Australia and New Zealand are both affluent, first world countries, child protection statistics indicate that much ground is yet to be covered with respect to ensuring that children are reared in environments that are safe and developmentally nourishing. Both neglect and abuse are associated with serious, pervasive and long-term sequelae for a range of neuropsychological functions, including expressive and receptive language abilities. In spite of its considerable body of knowledge regarding the nature and sequence of language development from infancy through to adulthood and across the lifespan, speech-language pathology (SLP) as a profession has failed to position itself as an agent of prevention where child safety is concerned. Language competence is acquired in the relational milieu of early infant-caregiver attachment, and cannot be separated out from mental health across the lifespan. Most significant mental health problems have their onset early in life, as do developmental language problems. Positioning SLP at the prevention table will require graduates of SLP programs to speak and understand the discourse of public health policy-making, advocacy, and resource-allocation, so that graduates can occupy positions of influence in government. At the current time, however, most undergraduate programs emphasize SLP as a 1:1 service-delivery profession, at the expense of important roles this profession could play in relation to prevention of language and mental health problems at a population level.