Rebecca J. McCauley

Treatment of childhood apraxia of speech: Clinical decision making in the use of nonspeech oral motor exercises

In this article, the authors provide background concerning the nature of childhood apraxia of speech (CAS) and conventional speech-based treatments for it. In addition they discuss a clinical decision-making process within which to consider the appropriateness of nonspeech oral motor exercises (NSOMEs). This process requires clinicians to ask questions of themselves as they interpret clinical observations and consider alternative treatment approaches (including both NSOMEs and speech-oriented treatments). Given a virtual absence of relevant empirical evidence on the question of the value of NSOMEs for children with CAS, clinicians are urged to examine the soundness of theoretical rationales they turn to when making clinical decisions.

Stuttering severity and responses to social-communicative challenge in preschool-age children who stutter

Abstract Purpose This study assessed indices of autonomic arousal and vocal tension during challenge in preschool-age children who do stutter (CWS) and do not stutter (CWNS). Method Participants were preschool-age CWS (n = 10) and gender- and age-matched CWNS (n = 10) who performed in two speaking conditions: (1) ‘low’ challenge – naming age-appropriate pictures in a familiar room with the same examiner who administered his/her speech-language prescreening test (2) ‘high’ challenge – recalling the pictures named in condition (1) in a different room with an unfamiliar examiner while wearing acoustic startle electrodes on his/her face. Immediately following the ‘high’ challenge speaking task, the participants’ acoustic startle eyeblink response (ASEB) was measured. Dependent variables were ASEB in the ‘high’ challenge condition and the acoustic measure of mean fundamental frequency (Fo) in both challenge conditions. Results Findings indicated no significant between-group (CWS vs. CWNS) differences in Fo or ASEB responses. However, CWS-severe (n = 5), when compared with CWS-mild/moderate (n = 5), exhibited a statistically significant increase in Fo in the ‘high’ challenge relative to the ‘low’ challenge condition. Conclusions Results were taken to suggest that preschool-age CWS-severe exhibit vocal tension while speaking in conditions of social (e.g. speaking to unfamiliar examiner) and communicative (e.g. recalling from memory names of pictures previously shown) challenge, and such vocal behavior is possibly associated with this subgroups difficulty establishing normally fluent speech.

Adolescent Summaries of Narrative and Expository Discourse: Differences and Predictors

Purpose Summarizing expository passages is a critical academic skill that is understudied in language research. The purpose of this study was to compare the quality of verbal summaries produced by adolescents for 3 different discourse types and to determine whether a composite measure of cognitive skill or a test of expressive syntax predicted their performance. Method Fifty adolescents listened to, and then verbally summarized, 1 narrative and 2 expository lectures (compare-contrast and cause-effect). They also participated in testing that targeted expressive syntax and 5 cognitive subdomains. Results Summary quality scores were significantly different across discourse types, with a medium effect size. Analyses revealed significantly higher summary quality scores for cause-effect than compare-contrast summaries. Although the composite cognitive measure contributed significantly to the prediction of quality scores for both types of expository summaries, the expressive syntax score only contributed significantly to the quality scores for narrative summaries. Conclusions These results support previous research indicating that type of expository discourse may impact student performance. These results also show, for the first time, that cognition may play a predictive role in determining summary quality for expository but not narrative passages in this population. In addition, despite the more complex syntax commonly associated with exposition versus narratives, an expressive syntax score was only predictive of performance on narrative summaries. These findings provide new information, questions, and directions for future research for those who study academic discourse and for professionals who must identify and manage the problems of students struggling with different types of academic discourse. Supplemental Material https://doi.org/10.23641/asha.6167879.

Elements of Phonological Interventions for Children With Speech Sound Disorders: The Development of a Taxonomy

Purpose Our aim was to develop a taxonomy of elements comprising phonological interventions for children with speech sound disorders. Method We conducted a content analysis of 15 empirically supported phonological interventions to identify and describe intervention elements. Measures of element concentration, flexibility, and distinctiveness were used to compare and contrast interventions. Results Seventy-two intervention elements were identified using a content analysis of intervention descriptions then arranged to form the Phonological Intervention Taxonomy: a hierarchical framework comprising 4 domains, 15 categories, and 9 subcategories. Across interventions, mean element concentration (number of required or optional elements) was 45, with a range of 27 to 59 elements. Mean flexibility of interventions (percentage of elements considered optional out of all elements included in the intervention) was 44%, with a range of 29% to 62%. Distinctiveness of interventions (percentage of an interventions rare elements and omitted common elements out of all elements included in the intervention [both optional and required]) ranged from 0% to 30%. Conclusions An understanding of the elements that comprise interventions and a taxonomy that describes their structural relationships can provide insight into similarities and differences between interventions, help in the identification of elements that drive treatment effects, and facilitate faithful implementation or intervention modification. Research is needed to distil active elements and identify strategies that best facilitate replication and implementation.

Exploring Summarization Differences for Two Types of Expository Discourse in Adolescents With Traumatic Brain Injury

Purpose Annually, nearly 700,000 U.S. children and adolescents experience a traumatic brain injury (TBI). Many of them struggle academically, despite failing to qualify for special education services because their cognitive communication impairments are subtle. Method In this exploratory study, five adolescents with TBI provided verbal summaries of two expository lectures (compare-contrast, cause-effect) and participated in cognitive and expressive syntax testing. Their performance on these tasks was compared descriptively to that of 50 adolescents with typical development. Results For adolescents with TBI, mean summary quality scores for both exposition types were at least 1 SD lower than those of adolescents with typical development and notably 2 SDs below for the cause-effect passage. The adolescents with TBI who had below-average cognitive scores showed better performance on compare-contrast summaries compared to cause-effect, whereas the majority of adolescents with typical development showed the opposite tendency. Conclusions These results provide preliminary evidence that students with TBI, particularly those with cognitive deficits, may struggle with expository discourse despite acceptable performance on a measure of expressive syntax. This study also indicates that researchers should explore how students with TBI perform on academically relevant discourse tasks in order to inform future assessment and intervention efforts. Supplemental Materials https://doi.org/10.23641/asha.5572786.