Speech-language pathologists' perspectives of communication strategies for young people in the New Zealand youth justice system

Purpose: Working in the justice system is a new and emerging area for speech-language pathologists (SLPs) in New Zealand, both in practice and research. This study explored SLPs' perspectives on: (1) the importance of implementing communication strategies in the New Zealand youth justice system, and (2) the effectiveness and relevance of the strategies employed.Method: A qualitative Phenomenology of Practice research approach was used. Five SLPs working as communication assistants in the New Zealand youth justice system were recruited through non-probability convenience sampling. Semi-structured interviews were conducted face-to-face or via video conference; these were audio recorded, transcribed, and analysed through an inductive coding process.Result: SLPs' perspectives on the importance of implementing strategies revealed two global themes: Complexities within Communication and Giving Young People a Voice. SLPs' perspectives on the effectiveness and relevance of the strategies used resulted in one global theme: SLP Role Goes Beyond Implementing Communication Strategies Alone.Conclusion: SLPs identified the need for their presence in the justice system due to the complexity of the environment. Participants perceived the current communication strategies were effective in equipping other professionals with skills to communicate with young people who offend. Recommended improvements to further assist young people's understanding were suggested.

Paths to language development in at risk children: a qualitative comparative analysis (QCA)

Background

Childhood language development is related to long term educational, employment, health and social outcomes. Previous research identifies a complex range of risk and protective factors which result in good and poor language outcomes for children, however children at risk are an underrepresented group in these studies. Our aim is to investigate the combinations of factors (paths) that result in good and poor language outcomes for a group of 5 year old children of mothers experiencing adversity.

Methods

This mixed methods study utilised longitudinal data from a randomised control trial of sustained home visiting (MECSH) to determine the language outcomes in at risk children. Mothers were randomly assigned to a comparison group at entry to the study (prior to child’s birth). Their children who were retained at entry to school completed language assessments (n = 41) and were participants in this study. Influence of 13 key factors derived from the extant literature that impact language development were explored. Regression was used to determine the six key factors of influence and these were used in the Qualitative Comparative Analysis (QCA). QCA was employed to examine the necessary and sufficient conditions and paths affecting language development linked to good and poor language outcomes. A post hoc analysis of the risk and protective paths to good and poor language outcomes was also conducted.

Results

Thirteen distinct pathways led to good language outcomes and four paths to poor language outcomes in five year old at risk children. A variety of condition combinations resulted in these outcomes, with maternal responsivity, toddler development and number of children in the home being key. High and low maternal education influenced both good and poor language development.

Conclusions

The paths to good and poor language outcomes were different and complex. Most paths to a good language outcome involved protective factors, though not always. In addition, paths to poor language more often involved risk factors. The varied patterns of risk and protective factors point to the need for interventions across the first five years of life in both health and education for families which can respond to these risk and protective patterns.

Trial registration

The original RCT was retrospectively registered in the ANCTR: ACTRN12608000473369.

Electronic supplementary material

The online version of this article (10.1186/s12887-019-1449-z) contains supplementary material, which is available to authorized users.

Education and employment outcomes of young adults with a history of developmental language disorder

BACKGROUND

Developmental language disorder (DLD) presents a considerable barrier for young adults to engage in further education and training. Early studies with young adults with DLD revealed poor educational achievement and lack of opportunities to progress in education. More recent studies have provided more positive findings. Relatively sparse data exist, however, on current cohorts and the factors that predict outcomes.

AIMS

To examine educational and employment outcomes in young adulthood in a sample of people with histories of DLD compared with an age-matched peer group without DLD. We ask: How do educational pathways and early jobs compare between those with and without DLD? Are young adults with DLD receiving similar levels of income as their peers? To what extent are language and literacy abilities associated with outcomes?

METHODS & PROCEDURES

Participants included 84 individuals with DLD (67% males) and 88 age-matched peers without DLD (56% males). Participants were on average 24 years of age. They completed a battery of psycholinguistic, literacy and nonverbal skills assessments. Data were also collected on educational qualifications, current educational status, extent of educational support received, employment status, history and support, as well as current income.

OUTCOMES & RESULTS

Those with DLD obtained lower academic and vocational qualifications. Higher educational/vocational qualifications were associated with better language, better reading and higher performance IQ (PIQ). There were few differences between the two groups in terms of engagement with education, but the mean age at leaving education was significantly earlier in the participants with DLD. Substantially more participants with DLD reported receiving support or dispensation from their educational institution. There was no significant difference between groups in the proportion of young people currently employed, though a higher proportion of the age-matched peers was in work full time. Participants with DLD were much more likely to be in non-professional occupations. However, when examining pay in relation to types of occupation, the groups' incomes were broadly comparable.

CONCLUSIONS & IMPLICATIONS

At the group level, young people with a history of DLD more commonly have less skilled employment and more rarely achieve professional roles. At the individual level there is considerable variation with smaller but not trivial proportions of young adults with a history of DLD showing good educational and employment outcomes. There are positive aspects to early adult outcomes for some young people with a history of DLD.

Specific language impairment: a convenient label for whom?

BACKGROUND

The term 'specific language impairment' (SLI), in use since the 1980s, describes children with language impairment whose cognitive skills are within normal limits where there is no identifiable reason for the language impairment. SLI is determined by applying exclusionary criteria, so that it is defined by what it is not rather than by what it is. The recent decision to not include SLI in DSM-5 provoked much debate and concern from researchers and clinicians.

AIMS

To explore how the term 'specific language impairment' emerged, to consider how disorders, including SLI, are generally defined and to explore how societal changes might impact on use the term.

METHODS & PROCEDURES

We reviewed the literature to explore the origins of the term 'specific language impairment' and present published evidence, as well as new analyses of population data, to explore the validity of continuing to use the term.

OUTCOMES & RESULTS AND CONCLUSIONS & IMPLICATIONS

We support the decision to exclude the term 'specific language impairment' from DSM-5 and conclude that the term has been a convenient label for researchers, but that the current classification is unacceptably arbitrary. Furthermore, we argue there is no empirical evidence to support the continued use of the term SLI and limited evidence that it has provided any real benefits for children and their families. In fact, the term may be disadvantageous to some due to the use of exclusionary criteria to determine eligibility for and access to speech pathology services. We propose the following recommendations. First, that the word 'specific' be removed and the label 'language impairment' be used. Second, that the exclusionary criteria be relaxed and in their place inclusionary criteria be adopted that take into account the fluid nature of language development particularly in the preschool period. Building on the goodwill and collaborations between the clinical and research communities we propose the establishment of an international consensus panel to develop an agreed definition and set of criteria for language impairment. Given the rich data now available in population studies it is possible to test the validity of these definitions and criteria. Consultation with service users and policy-makers should be incorporated into the decision-making process.

Progress in Understanding Adolescent Language Disorders

Purpose

This prologue introduces a clinical forum on adolescent language disorders, a topic that has long been of interest to school-based speech-language pathologists/therapists.

Method

A rationale for the clinical forum is provided, and the content is contrasted with a previous forum on the same topic that was published nearly 20 years ago. Implications and directions for future research and practice in adolescent language disorders are discussed.

Conclusions

Considerable progress has occurred in our understanding of the nature, assessment, and treatment of language and communication disorders in adolescents and young adults. Yet we continue to need to build the evidence base on the most effective and efficient ways of enhancing the spoken and written language skills of young people with language and communication disorders in academic, social, emotional, and vocational domains.