There can be wide variation in the level of oral/aural language ability that prelingually hearing-impaired children develop after cochlear implantation. Automatic perceptual processing mechanisms have come under increasing scrutiny in attempts to explain this variation. Using mismatch negativity methods, this study explored associations between auditory sensory memory mechanisms and verbal working memory function in children with cochlear implants and a group of hearing controls of similar age. Whilst clear relationships were observed in the hearing children between mismatch activation and working memory measures, this association appeared to be disrupted in the implant children. These findings would fit with the proposal that early auditory deprivation and a degraded auditory signal can cause changes in the processes underpinning the development of oral/aural language skills in prelingually hearing-impaired children with cochlear implants and thus alter their developmental trajectory.
• Non-computerised training can improve working memory and near-transfer skills. • Training other skills (physical activity, play, inhibition) is beneficial indirectly. • Tapping into attentional resources (executive control) is key to task effectiveness. • Further studies need clear theoretical underpinnings and rigorous methodology. • Outcome measurement and dosage need greater consideration.
7 July 2020 in International Journal of Speech-Language Pathology
Purpose: The aim of this study was to explore the reasons behind speech-language pathologists’ (SLPs’) current clinical practices (intervention and intensity provision) for children (0–18 years) with phonological impairment. Method: Three focus groups each with five SLPs and six 1:1 interviews with SLP managers from one region of the UK (n = 21) were carried out. A thematic analysis was undertaken. Result: SLPs often used an eclectic mix of familiar approaches with easily-accessible therapy materials. SLPs only reported deviating from their core approach if the child did not progress in therapy. Mixed responses were gathered on the perceived feasibility of transferring evidence-based intervention intensities into clinical practice. The importance of parents to increase intensity provision at home was noted. Barriers to SLPs’ evidence-based decision-making included: time; confidence levels; service-related restrictions and; difficulty replicating research in practice. Having peer support and access to decision-making pathways and manualised intervention protocols were considered ways to overcome these barriers. Conclusion: There is a research-practice gap in which SLPs’ current practices are driven by organisational factors, their own preferences and child-specific factors. To narrow this gap, SLPs suggested the development of time-saving, evidence-based tools.
Speech sound disorder (SSD) affects up to 25% of UK children and may impact on: effective communication; the development of relationships; school progression and overall well-being. The evidence base shows that intervention for children with SSD is more effective and efficient when provided intensively in relation to the number of target sounds elicited in sessions (dose) and number of sessions per week (frequency). Southern Health and Social Care (HSC) Trust's baseline intensity of speech and language therapy (SLT) intervention was similar to that often found in current practice across the UK,where ~30 target sounds were elicited (dose) in once weekly sessions (frequency) over a 6-week block, followed by a break from therapy. This quality improvement (QI) project aimed to increase intensity of intervention for children with severe SSD within Southern HSC Trust’s community SLT service to improve outcomes for children and their parents. QI methods supported accurate identification of ten 4–5 year olds with severe SSD and increased the intensity of their intervention over a 12-week period by measuring a range of data and speech outcomes. Findings showed a sustainable increase of dose (number of targets elicited per session) to levels recommended in the research (≥70). However, it was difficult to sustain increased frequency of appointments (to twice weekly) because of contextual factors such as sickness, etc. Accommodating this, measuring days between appointments captured an overall increase in the number of appointments attended across time. Child speech outcomes improved for direct speech measures and parent ratings of intelligibility. The intensive model of intervention has been implemented for children identified with severe SSD across Southern HSC Trust's community service with ongoing audit and development, and findings have been disseminated.
31 August 2017 in Clinical Linguistics & Phonetics
Accuracy of phonetic transcription is a core skill for speech and language therapists (SLTs) worldwide (Howard & Heselwood, 2002). The current study investigates the value of weekly independent online phonetic transcription tasks to support development of this skill in year one SLT students. Using a mixed methods observational design, students enrolled in a year one phonetics module completed 10 weekly homework activities in phonetic transcription on a stand-alone tutorial site (WebFon (Bates, Matthews & Eagles, 2010)) and 5 weekly online quizzes (the ‘Ulster Set’ (Titterington, unpublished)). Student engagement with WebFon was measured in terms of the number of responses made to ‘sparks’ on the University’s Virtual Learning Environment Discussion Board. Measures of phonetic transcription accuracy were obtained for the ‘Ulster Set’ and for a stand-alone piece of coursework at the end of the module. Qualitative feedback about experience with the online learning was gathered via questionnaire. A positive significant association was found between student engagement with WebFon and performance in the ‘Ulster Set’, and between performance in the ‘Ulster Set’ and final coursework. Students valued both online independent learning resources as each supported different learning needs. However, student compliance with WebFon was significantly lower than with the ‘Ulster Set’. Motivators and inhibitors to engagement with the online resources were investigated identifying what best maximised engagement. These results indicate that while ‘independent’ online learning can support development of phonetic transcription skills, the activities must be carefully managed and constructively aligned to assessment providing the level of valance necessary to ensure effective engagement.