Consensus on Terminology for Describing Child Language Interventions: A Delphi Study

Photobiomodulation on vocal training and rehabilitation: Delphi consensus based on experts

PURPOSE

To develop a consensus among speech-language pathologists who are voice specialists regarding the criteria for recommending and using photobiomodulation in the context of vocal therapy and training.

METHODS

Seven speech-language pathologists, experts in voice, and with experience in using photobiomodulation in vocal therapy and training participated. The Delphi technique was used to achieve consensus from a panel of experts accessed independently in two phases of collection. In Phase 1, the experts were contacted individually and participated in an interview with 12 questions to gather opinions on the use of photobiomodulation in the investigated context. The experts' responses were used to construct a questionnaire with 55 items presented as statements. The experts were asked to analyze each item and indicate their level of agreement on a five-point Likert scale. The content validity coefficient (CVC) was used to investigate the degree of agreement among the judges and to select the final items of the consensus.

RESULTS

Consensus was reached among the experts on 34 items investigated in this study, with a CVC ≥ 0.75. It was observed that 31 items achieved an excellent CVC (≥ 0.78), 14 items with a good CVC (0.60 ≥ CVC ≤ 0.77) and 10 items with a poor CVC (≤ 0.59). The total CVC was considered excellent, with a value of 0.78.

CONCLUSION

There was a consensus among experts about the use of photobiomodulation in vocal habilitation and rehabilitation. It has the potential to improve the criteria for prescribing and using this device by speech-language pathologists. The findings may be useful to improve the criteria for prescribing and the use of this device by speech-language pathologists, in addition to subsidizing the development of future research and clinical recommendations in the area.

Applying behaviour change theory to parent-led language interventions for children in the early years

BACKGROUND

The aim of many interventions used by speech and language therapists (SLTs) is to change behaviours related to communication and interaction. Parent-led language interventions for children in the early years (0-5 years) rely on SLTs supporting parents to change their behaviour in child-focused interactions to effect a change in the child's communication. Therapeutic techniques used by SLTs in parent-led language interventions are largely underspecified, impacting on intervention reporting, replication, trialling and development. The Behaviour Change Technique Taxonomy Version 1 (BCTTv1) offers a method of describing intervention techniques developed for use in public health interventions, but with several examples of its application to speech and language interventions.

AIMS

To identify behaviour change techniques (BCTs) from the BCTTv1 occurring in parent-led language interventions for children in the early years.

METHODS & PROCEDURES

A literature search identified relevant descriptions of parent-led language interventions. These were coded using the BCTTv1. A reliability check was carried out on 10% of the descriptions. To confirm the use of identified BCTs in clinical practice, results of the literature search were triangulated with an online survey of SLTs, and observations of SLTs delivering parent-led language intervention.

OUTCOMES & RESULTS

A total of 84 papers containing descriptions of 45 interventions were coded; 62 SLTs responded to the survey and three SLTs were observed delivering parent-led language intervention. A total of 24 BCTs were identified in the literature search, replicated in the observations and verified by SLTs in the survey. BCTs were identified at two levels: Level 1 SLT implemented to change parent interactive behaviour; and Level 2 parent implemented to change child communicative behaviour.

CONCLUSIONS & IMPLICATIONS

The BCTTv1 is a useful starting place for describing parent-led language interventions. With some additions and adjustments, BCTs identified in this study were immediately recognized by practitioners and can easily be adopted into practice.

WHAT THIS PAPER ADDS

What is already known on this subject Techniques used in SLT interventions are often not clearly described. The BCTTv1 has been used to clarify technique descriptions with success in a small number of SLT disciplines, but not yet in parent-led language interventions for preschoola children. What this paper adds to the existing knowledge This paper constitutes the first research into quantifying the techniques used in parent-led language interventions using the BCTTv1. What are the potential or actual clinical implications of this work? This paper provides a clear list of techniques used by SLTs implementing interventions for preschool children, which can be immediately adopted and used in practice. It also highlights potential adjustments and gaps in the BCTTv1 in relation to SLT which can contribute to future iterations.

Evidence-Based Expository Intervention: A Tutorial for Speech-Language Pathologists

PURPOSE

This tutorial guides speech-language pathologists (SLPs) through the research base for expository intervention and evidence-based decision making for clinical implementation.

METHOD

In the first half of the tutorial, the nature and development of expository discourse is described, and then attention is turned to the research base that informs SLP expository intervention. The many educational domains in which relevant research can be found and the diverse terminology used are explained. From reading comprehension and compositional writing, two areas with strong research evidence that are suitable to SLP use-text structure and learning strategies-are identified. The second half of the tutorial focuses on crafting SLP interventions from the educational evidence. An expository intervention designed specifically for SLPs from this research base, called Sketch and Speak, is presented. In this intervention, visual and written note-taking strategies are combined with oral formulation and practice strategies and taught through individualized oral interactions around informational texts. SLPs are guided on how to adapt this and other expository treatments to their own priorities and service delivery situations while maintaining quality features or "active ingredients" of researched treatments.

CONCLUSIONS

There is considerable educational research on expository intervention. From this literature, SLPs can strategically adopt and adapt to implement evidence-based interventions to help students understand, speak, and write in this important discourse form.

A Mixed-Methods Analysis of Speech-Language Pathologists' Executive Function Services

PURPOSE

The purpose of this study was to examine school-based speech-language pathologists' (SLPs') implementation of services to address students' executive function (EF) needs, with particular emphasis on the prevalence and characteristics of EF interventions and the factors and barriers that influence service provision for students with EF needs.

METHOD

We applied an explanatory sequential mixed-methods research design, beginning with a quantitative survey followed by a series of qualitative interviews. We analyzed the survey results using descriptive data and binary logistic regressions and used the emergent trends to inform our interview protocol, so that we could explore those trends in greater detail and context. We synthesized our quantitative and qualitative data to evaluate the characteristics of EF interventions and the factors influencing services.

RESULTS

Most SLPs reported that they addressed their students' EF needs through some sort of direct or indirect intervention. Direct interventions varied by targeted domain, service delivery setting, and teaching techniques, though most SLPs favored strategy instruction and highly contextualized services. Indirect services included accommodations and consultation. SLPs commonly reported the lack of collaborative support, time, and knowledge as barriers, and most reported that professional development would be helpful to improve their services.

CONCLUSIONS

Speech-language pathology graduate programs and providers of professional development should be mindful of their role in preparing SLPs to address EF needs, while SLPs may use these results to inform their own practice. Further guidance and research are necessary to elucidate the SLPs' role in mitigating the negative impact of EF challenges on students' education.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.24101241.

Editorial Perspective: Maximising the benefits of intervention research for children and young people with developmental language disorder (DLD) - a call for international consensus on standards of reporting in intervention studies for children with and at risk for DLD

Current methods for reporting interventions do not allow key questions of importance to practitioners, service providers, policy-makers and people with DLD to be answered, and hence limit the implementation of effective interventions in the real world. To extend the existing EQUATOR guidelines to the context of speech language therapy/pathology for children with language disorder and to provide more specific guidance on participants, interventions and outcomes within the CONSORT checklist (used to improve the reporting of randomised controlled trials) and TIDieR (Template for Intervention Description and Replication) to ensure consistency of reporting. We will develop a core team to include representatives from each of the key groups who will either use or be influenced by the final reporting guidance across different countries. To achieve each set of aims, we will conduct reviews of the literature (which present typologies of intervention characteristics in (D)LD and related disorders); carry out focus groups; and use systematic consensus methods such as the Delphi technique, nominal group technique or consensus development conferences. Through the development and adoption of standard intervention reporting criteria, we anticipate that we will overcome the numerous barriers for practitioners, services and policy-makers in applying intervention evidence to practice. We believe that establishing international consensus on reporting guidelines would significantly accelerate progress in DLD research and the ease with which it can be used in clinical practice, by capitalising on the growth in intervention studies to enable international collaboration and new methodologies of data pooling, meta-analyses and cross-study comparisons.

Caregiver-Implemented Communication Interventions for Children Identified as Having Language Impairment 0 Through 48 Months of Age: A Scoping Review

PURPOSE

Caregiver-implemented interventions are frequently used to support the early communication of young children with language impairment. Although there are numerous studies and meta-analyses supporting their use, there is a need to better understand the intervention approaches and identify potential gaps in the research base. With that premise, we conducted a scoping review to synthesize existing data with an end goal of informing future research directions.

METHOD

We identified relevant studies by comprehensively searching four databases. After deduplication, we screened 5,703 studies. We required included studies (N = 59) to evaluate caregiver-implemented communication interventions and include at least one caregiver communication outcome measure. We extracted information related to the (a) study, child, and caregiver characteristics; (b) intervention components (e.g., strategies taught, delivery method and format, and dosage); and (c) caregiver and child outcome measures (e.g., type, quality, and level of evidence).

RESULTS

We synthesized results by age group of the child participants. There were no studies with children in the prenatal through 11-month-old age range identified in our review that yielded a caregiver language outcome measure with promising or compelling evidence. For the 12- through 23-month group, there were seven studies, which included eight communication intervention groups; for the 24- through 35-month group, there were 21 studies, which included 26 intervention groups; and for the 36- through 48-month group, there were 21 studies, which included 23 intervention groups. Across studies and age groups, there was considerable variability in the reporting of study characteristics, intervention approaches, and outcome measures.

CONCLUSION

Our scoping review highlights important research gaps and inconsistencies in study reporting that should be addressed in future investigations.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.20289195.

The Effects of Language Instruction on Math Development

How does language shape mathematical development? In this article, we consider this question by reviewing findings from cross-sectional and longitudinal research. In this literature, we find that differences in the structures of languages and individual variation in language ability are associated with mathematical performance in both obvious and unexpected ways. We then consider the causal nature of these relations, with a focus on experimental studies that have tested the effects of language instruction on mathematical outcomes. Findings from this work show that certain forms of language instruction meaningfully improve performance in several mathematical domains, providing strong evidence of a linguistic pathway in mathematical development. However, much additional research is needed to understand how language instruction may be integrated optimally into math education. We conclude with recommendations for research.

Intervention Goals for Preschoolers With Language Difficulties and Disorders: A Scoping Review Using the International Classification of Functioning, Disability and Health Framework

PURPOSE

The primary aim of this scoping review was to categorize language therapy goals reported in intervention studies for preschoolers (i.e., children from birth to 5;0 [years;months]) with language difficulties and disorders within the World Health Organization's International Classification of Functioning, Disability and Health (ICF) framework. A secondary aim was to determine whether different therapy goals were reported for two language difficulty/disorder subtypes (i.e., comparing language difficulty/disorder associated with a biomedical condition to those without an associated biomedical condition).

METHOD

The scoping review followed Arksey and O'Malley (2005) guidelines. Articles were retrieved from speechBITE, with age (under 5 years), intervention area (language), and study design (all but systematic reviews and clinical practice guidelines) specified as inclusion criteria. Language goals were extracted and categorized into the ICF components, and the distribution of goals across ICF components was compared for studies involving children with the two language difficulty/disorder subtypes.

RESULTS

A total of 287 articles were identified; 140 met inclusion criteria. Of the 293 goals extracted, 48% aligned with the activities component of the ICF framework, followed by participation (26%), environmental factors (20%), body functions and structures (3%), and personal factors (3%). Most participation-focused goals were reported from intervention studies involving preschoolers with a language difficulty/disorder associated with a biomedical condition.

CONCLUSIONS

Few participation-focused goals were reported in intervention studies for preschoolers with language difficulty/disorder without an associated condition. Future work is needed to support integrating the ICF framework in goal setting for both research and practice.