Early Development of Emotional Competence (EDEC) Assessment Tool for Children With Complex Communication Needs: Development and Evidence

A systematic review of self-regulation measures in children: Exploring characteristics and psychometric properties

Self-regulation, which encompasses cognitive, behavioural, and emotional domains, poses challenges in consistent measurement due to diverse definitions and conceptual complexities. In recognition of its profound impact on long-term mental health and wellbeing in children, this systematic review examined available self-regulation measures for children and young people between 1 and 18 years of age. The systematic review followed the COSMIN taxonomy and reported on the measurement tools' characteristics and psychometric properties. The methodology and reporting were guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and checklist. The protocol for this review was registered with PROSPERO (Number CRD42020155809). A search of six databases (Embase, MEDLINE, PsycINFO, Scopus, CINAHL and ERIC) was performed, and grey literature was searched to identify studies on the psychometric properties of measures assessing all three domains (cognitive, behavioural, and emotional) of self-regulation. The types of psychometric properties were examined against the COSMIN taxonomy of measurement properties. A total of 15,583 studies were identified, and 48 of these met the criteria that reported psychometric properties of 23 self-regulation measures assessing all three domains of self-regulation. Most measures relied on self-reports for ages 11-17, and all had limited psychometric evaluation. The Emotion Regulation Checklist was the most studied measure. Notably, none of the studies evaluated measurement error. The content validity was inadequately evaluated, particularly in terms of comprehensiveness and comprehensibility. Future research should focus on developing measures for young children, evaluating measurement error, and enhancing content validity for comprehensive understanding and effective intervention.

Supporting Access to Mental Health Services for Patients Who Use Augmentative and Alternative Communication: A Proposed Framework and Suggestions for Future Directions

PURPOSE

The purpose of this review article is to examine interacting factors that affect the psychotherapeutic process for patients who use augmentative and alternative communication (AAC). This is examined from two perspectives: (a) how the skills and needs brought by the individual with communication disabilities influence the process of therapy and (b) how the individual's ecological systems may affect an individual's mental health and their access to mental health supports. Understanding these factors will guide future efforts aimed at ensuring that individuals with communication disorders have adequate access to services and supports for mental health.

METHOD

A narrative synthesis approach was used to explore the interaction of psychotherapy and the use of AAC. Existing research in the fields of psychotherapy and speech-language pathology was examined for its relevance to issues of communication using AAC. Specifically, information was synthesized concerning mental health, prevalence rates of mental health diagnoses, the provision of traditional psychotherapy, and communicating via AAC in order to describe the intersection of psychotherapy and AAC. This narrative synthesis approach sought to initiate discussion of relevant factors that may affect the psychotherapeutic process for patients who use AAC.

RESULTS

A variety of factors may affect the psychotherapeutic process for patients who use AAC. Bronfenbrenner's (1977) Ecological Systems Theory was used to explore access to mental health services for individuals who use AAC at the levels of microsystem, mesosystem, exosystem, and macrosystem. Such factors include alterations to communication between patient and psychotherapist, skills brought by the patient, involvement of a communication assistant and/or speech-language pathologist, education and skill level of the psychotherapist, appropriateness of billing codes, and system and policy factors that may affect the provision of mental health services to patients who use AAC.

CONCLUSION

It is necessary to explore the factors that affect the provision of psychotherapy for patients who use AAC in order to more fully address the mental health needs of individuals with communication disorders. Further research is needed to determine the impacts of these factors and ways to address those impacts.

Mental State Language Use in Children with Down Syndrome and the Role of Caregivers

Children with Down syndrome (DS) have both strengths and difficulties in speech, language, and social communication. Mental state language-the ability to discuss others' perspectives such as their thoughts, feelings, and intentions-represents a foundational social communicative skill that is delayed in many children with DS, even into the school-age years. The purpose of this article is to review the evidence base on mental state language development in school-age children with DS, focusing in particular on assessment and intervention. We discuss assessment procedures that are both age appropriate and developmentally appropriate for this population. We also present preliminary data highlighting the role of caregivers in supporting mental state language development in school-age children with DS through shared storytelling. We propose that interventions aimed at supporting mental state language development in DS should include a focus on caregiver-child shared storybook reading, even in the school-age years. Therefore, we discuss key considerations for clinicians when teaching caregivers strategies for supporting mental state language and social communication in children with DS.

Encouraging Emotional Conversations in Children With Complex Communication Needs: An Observational Case Study

Children with complex communication needs (CCN) regularly have barriers to express and discuss emotions, and have fewer opportunities to participate in emotional conversations. The study explores and analyzes the changes after a training program focused on offering an interactive home learning environment that encouraged and modeled emotion-related conversations between a parent and a child with CCN within storybook-reading contexts. An observational design (nomothetic/follow-up/multidimensional) was used to explore and analyze the changes in the communicative interaction around emotions between mother-child. Augmentative and alternative communication (AAC) technologies were used to provide the child access to emotion-related vocabulary. The training program resulted in the mother providing more opportunities to engage her child in emotional conversations, suggesting that when opportunities and resources to talk about emotions were promoted, the child showed more engagement in emotion-related conversations using his AAC system. The mother-child communicative patterns and behavioral relationships observed during the phases are also presented. This case study illustrates the importance of a primary communication partners' role in facilitating emotional conversations, and the promising efficacy of a training program implemented in a storybook interactive learning environment to promote conversations about emotion-related events while encouraging children with CCN to learn, explore, express, and discuss emotions.

The Early Development of Emotional Competence Profile: A Means to Share Information About Emotional Status and Expression by Children With Complex Communication Needs

Purpose This clinical focus article introduces a summary profile template, called the Early Development of Emotional Competence Profile (EDEC-P). This profile distills information from a longer interview tool that solicits a detailed case history (the EDEC), but in a format that is readily accessible for communication partners of children with complex communication needs, including parents, educators, and other professionals. Method In this clinical focus article, we will (a) introduce the EDEC-P structure, (b) illustrate via case examples the types of information that can be shared, and (c) offer preliminary feedback from parents and other professionals on its usefulness. We will review literature that supports the importance of scaffolding communication about emotions by specialists who work with children with complex communication needs and by parents and other communication partners. Results An EDEC-P was generated for two participants as an illustration of the process. Feedback was solicited from these children's parents and other communication partners. The feedback demonstrated that the EDEC-P was viewed as a positive tool and identified some of the ways that it might be used. Conclusions The EDEC-P may be useful for professionals who are interested in approaching communication about emotions in children with complex communication needs. Guidelines are proposed to present and discuss the results from the interview to support the decision-making process in the clinical practice and next steps in research. Supplemental Material https://doi.org/10.23641/asha.14219777.

Cross-Sectional Trajectories of Mental State Language Development in Children With Down Syndrome

Purpose This article (a) examined the cross-sectional trajectories of mental state language use in children with Down syndrome (DS) and (b) identified developmental factors associated with its use. Method Forty children with DS aged 6-11 years generated stories from a wordless picture book and completed an assessment battery of other linguistic, cognitive, and social-emotional skills. Their narratives were coded for mental state language density (the proportion of utterances containing mental state references) and diversity (the number of different mental state terms used). Results The emergence of mental state language use during narrative storytelling was observed across the sample; 0%-24% of children's utterances included references to mental states, and a variety of mental state terms were produced. Cross-sectional developmental trajectory analysis revealed that expressive vocabulary and morphosyntax were significantly related to increased mental state language density and diversity. Nonverbal emotion knowledge was significantly related to greater diversity of mental state terms used. Age and nonverbal cognition were not significant factors. Conclusions This first in-depth, within-syndrome characterization of mental state language use by school-age children with DS provides an important next step for understanding mental state and narrative development in this population. By identifying skills associated with the development of mental state language, this study provides an avenue for future longitudinal research to determine causal relationships, ultimately informing intervention efforts.