Search Results (60)

A cascading coaching model was used to teach bilingual speech-language pathology (SLP) graduate student clinicians and Spanish-speaking caregivers to implement naturalistic developmental behavioral intervention (NDBI) techniques with autistic preschoolers. Two triads (each consisting of a graduate student clinician, a minimally vocal child diagnosed with autism, and a caregiver) participated in the study. Following the cascading approach, a lead instructor (with limited Spanish conversational skills) coached bilingual student clinicians (in English) to apply culturally adapted NDBI with child participants. Following additional instruction in coaching, student clinicians coached caregivers in Spanish. Effects were evaluated using a multiple methods approach consisting of multiple probes across participants single case experimental design and a qualitative analysis of semi-structured interviews with adult participants. All adult participants increased their use of targeted NDBI skills including elicitation techniques (creating communication temptations, using wait time, and prompting) and response techniques (reinforcing children’s communication with natural consequences and providing a contextually relevant vocal model), demonstrating large to very large effect sizes. Although qualitative findings indicated areas for improvement (e.g., additional Spanish supports for clinicians), thematic analysis revealed additional benefits in terms of positive changes across adult learning, behavior, and perspectives; child communication; and child-caregiver relationships. Full article

Virtual Reality (VR) is a useful educational tool in healthcare, allowing students to practise and improve practical skills. In speech therapy (ST), the need to revise academic curricula to adapt them to university contexts and integrate them into advanced clinical practices has highlighted the need to analyse the use of VR in this sector. The objective of this scoping review was to investigate whether research has considered using VR to support ST students’ training and highlight potential gaps in the literature. The study followed the JBI methodology for scoping reviews and was reported according to PRISMA-ScR guidelines. A protocol to conduct the current review was developed and registered on the Open Science Framework. The articles considered were retrieved from databases specialising in healthcare, computer science, and education, and were enhanced by results found with the help of AI-based tools. No constraints were applied and all study types were considered. Fourteen studies were included in the review and analysed under four core subjects: VR technology, ST context, training purposes, and main outcomes and assessment methods. The VR types identified in the studies were grouped into four categories, i.e., non-immersive VR (6/14, 42.9%), immersive VR (5/14, 35.7%), non-specified VR type (2/14, 14.3%), and semi-immersive VR (1/14, 7.1%). Most studies (5/14, 35.7%) focused on clinical skills acquisition, others addressed communication and interpersonal collaborative skills (3/14, 21.4%), while the remaining focused on person-centred care and awareness, clinical interviewing or reasoning skills, and performance knowledge (2/14 each, 14.3%). VR is still in its early stages in ST education. Some recent studies suggest VR supports students’ communication, interdisciplinary, and clinical skills. Although still limited in the context of ST education, the increasing affordability and ease of development of VR, along with its growing use in other healthcare fields, suggest that its underuse might be due to institutional barriers and lack of standardised frameworks. Overall, the findings suggest that VR offers promising support for experiential and skills-based learning. Full article

Amyotrophic Lateral Sclerosis (ALS) is a neurodegenerative disorder that progressively impairs motor and communication abilities. Globally, the prevalence of ALS was estimated at approximately 222,800 cases in 2015 and is projected to increase by nearly 70% to 376,700 cases by 2040, primarily driven by demographic shifts in aging populations, and the lifetime risk of developing ALS is 1 in 350–420. Despite international advancements in assistive technologies, a recent national survey in Saudi Arabia revealed that 100% of ALS care providers lack access to eye-tracking communication tools, and 92% reported communication aids as inconsistently available. While assistive technologies such as speech-generating devices and gaze-based control systems have made strides in recent decades, they primarily support English speakers, leaving Arabic-speaking ALS patients underserved. This paper presents SOUTY, a cost-effective, mobile-based application that empowers ALS patients to communicate using gaze-controlled interfaces combined with a text-to-speech (TTS) feature in Arabic language, which is one of the five most widely spoken languages in the world. SOUTY (i.e., “my voice”) utilizes a personalized, pre-recorded voice bank of the ALS patient and integrated eye-tracking technology to support the formation and vocalization of custom phrases in Arabic. This study describes the full development life cycle of SOUTY from conceptualization and requirements gathering to system architecture, implementation, evaluation, and refinement. Validation included expert interviews with Human–Computer Interaction (HCI) expertise and speech pathology specialty, as well as a public survey assessing awareness and technological readiness. The results support SOUTY as a culturally and linguistically relevant innovation that enhances autonomy and quality of life for Arabic-speaking ALS patients. This approach may serve as a replicable model for developing inclusive Augmentative and Alternative Communication (AAC) tools in other underrepresented languages. The system achieved 100% task completion during internal walkthroughs, with mean phrase selection times under 5 s and audio playback latency below 0.3 s. Full article

Autism spectrum disorder (ASD) deals with several symptoms, including language and speech impairment and developmental delays. The main brain regions affected could be the prefrontal cortex (PFC) or the temporal lobe. The detrimental features could include oxidative stress, mitochondrial dysfunction, and neuroinflammation. Most often, these phenomena are interrelated and can lead to one another, creating a vicious cycle. They also influence the regulation of certain genes involved in the pathogenesis of ASD or related behavior. In the brain regions prone to these detrimental features, a cascade of free radicals, inflammatory cytokines, and mitochondrial energy disruptions is initiated. These actions during the prenatal or developmental stage of the child potentially lead to ASD symptomatic features, such as social isolation, communication difficulty, speech and language impairment, cognitive dysfunction, and intellectual disability. The more recent theories, including genetics, epigenetics, and the gut–brain axis, have been demonstrated to play a greater role in ASD pathology, often being associated with the more common ones as mentioned above. We also introduced some of the neurological disorders possessing shared genetic and behavioral traits with ASD. Many genes playing a role in ASD-like features and their potential targeted drugs were explained briefly. However, there are limited therapeutic options, and molecular pathways related to this disorder are less explored. Currently, researchers and therapists are racing to uncover a concrete remedy. This review also provides a brief outline of potential antioxidant, mitochondrial, and anti-inflammatory therapies. We finally included some novel strategies to diagnose and manage autistic pathology and symptoms. Full article

Background/Objective: Puberphonia is a voice disorder characterized by the persistence of a high-pitched voice in sexually mature males. In phoniatrics and speech-language pathology, it is also known as post-mutational voice instability, mutational falsetto, persistent fistulous voice, or functional falsetto. The absence of an age-appropriate vocal pitch may adversely affect psychological well-being and hinder personal, social, and occupational functioning. The aim of this study was to evaluate of the impact of phoniatric and logopedic rehabilitation on voice quality in patients with puberphonia. Methods: The study included 18 male patients, aged 16 to 34 years, rehabilitated for voice mutation disorders. Phoniatric and logopedic rehabilitation included voice therapy tailored to each subject. A logopedist led exercises aimed at lowering and stabilizing the pitch of the voice and improving its quality. A phoniatrician supervised the therapy, monitoring the condition of the vocal apparatus and providing additional diagnostic and therapeutic recommendations as needed. The duration and intensity of the therapy were adjusted for each patient. Before and after voice rehabilitation, the subjects completed the following questionnaires: the Voice Handicap Index (VHI), the Vocal Tract Discomfort (VTD) scale, and the Voice-Related Quality of Life (V-RQOL). They also underwent an acoustic voice analysis. Results: Statistical analysis of the VHI, VTD, and V-RQOL scores, as well as the voice’s acoustic parameters, showed statistically significant differences before and after rehabilitation (p < 0.005). Conclusions: Phoniatric and logopedic rehabilitation is an effective method of reducing and maintaining a stable, euphonic male voice in patients with functional puberphonia. Effective voice therapy positively impacts selected aspects of psychosocial functioning reported by patients, improves voice-related quality of life, and reduces physical discomfort in the vocal tract. Full article

Background/Objectives: Communication disorders in childhood, including expressive, receptive, pragmatic, and fluency impairments, have been consistently linked to mental health challenges such as anxiety, depression, and behavioural difficulties. However, existing research remains fragmented across diagnostic categories and developmental stages. This scoping review aimed to synthesise empirical evidence on the relationship between communication disorders and mental health outcomes in children and adolescents and to identify key patterns and implications for practice and policy. Methods: Following the PRISMA Extension for Scoping Reviews (PRISMA-ScR) and Arksey and O’Malley’s framework, this review included empirical studies published in English between 2000 and 2024. Five databases were searched, and ten studies met the inclusion criteria. Data were charted and thematically analysed to explore associations across communication profiles and emotional–behavioural outcomes. Results: Four interconnected themes were identified: (1) emotional and behavioural manifestations of communication disorders; (2) social burden linked to pragmatic and expressive difficulties; (3) family and environmental stressors exacerbating child-level challenges; and (4) a lack of integrated care models addressing both communication and mental health needs. The findings highlight that communication disorders frequently co-occur with emotional difficulties, often embedded within broader social and systemic contexts. Conclusions: This review underscores the need for developmentally informed, culturally responsive, and interdisciplinary service models that address both communication and mental health in children. Early identification, family-centred care, and policy reforms are critical to reducing inequities and improving outcomes for this underserved population. Full article

In health professions education, the hidden curriculum is a set of implicit rules and expectations about how clinicians act and what they value. In fields that are very homogenous, such as rehabilitation professions, these expectations may have outsized impacts on students from minoritized backgrounds. This qualitative study examined the hidden curriculum in rehabilitation graduate programs—speech-language pathology, occupational therapy, and physical therapy—through the perspectives and experiences of 21 students from minoritized backgrounds. Semi-structured interviews explored their experiences with their programs’ hidden curricula. These revealed expectations about ways of being, interacting, and relating. Three overarching themes emerged, each reflecting tensions between conflicting values: (i) blend in but stand out; (ii) success lies in individualism, while de-prioritizing the individual; and (iii) fix the field, using your identities as a tool. When the expectations aligned with students’ expectations for themselves, meeting them was a source of pride. However, when the social expectations clashed with their own culture, dis/ability, gender, or neurotype, these tensions became an additional cognitive burden, and they rarely received mentorship for navigating it. Health professions programs might benefit from fostering students’ critical reflection on their hidden curricula and their fields’ cultural norms to foster greater belonging, agency, and identity retention. Full article

Background: Tele-practice, as an evidence-based practice, has gained momentum over the last two decades. However, routine clinical adoption is not spontaneous. Implementation science facilitates stakeholder engagement and the assessment of needs and plans. The study aims to assess the needs related to audiology and speech–language pathology services for children under six years of age and readiness for a tele-practice-based model of care for diagnostic and rehabilitation services among parents within the public sector in Tamil Nadu. Methods: A cross-sectional study design was used. The qualitative methods of focus group discussions and semi-structured interviews were conducted for parents of children with disabilities. A quantitative community survey was conducted on parents of children with no known disabilities. A deductive-inductive method of analysis was used. Results: Community survey responses were analyzed using percentage analysis. The results were classified based on the constructs of Bowen’s feasibility framework: demand/need for tele-practice, acceptability of tele-practice, and integration and practicality of tele-practice. Parents considered the existing services to be inadequate. Parents perceived tele-practice as beneficial, yet they felt a hybrid method would be more suitable, with sufficiently interspersed in-person visits. Parents believed that training and community awareness were necessary before implementing a technology-based model of services. Conclusions: The study’s findings guided the fine-tuning of the proposed comprehensive tele-practice model for hearing and speech–language services for children in this rural district. Full article

Background: This study presents a comprehensive investigation into the correlation between Rare Diseases and Syndromes (RDS) and the dysphagic disorders manifested during childhood and adulthood in affected patients. Dysphagia is characterized by difficulty or an inability to swallow food of any consistency, as well as saliva or medications, from the oral cavity to the stomach. RDS often present with complex and heterogeneous clinical manifestations, making it challenging to develop standardized diagnostic and therapeutic approaches. Dysphagia can arise from various etiologies, including those related to the central nervous system, inflammatory and neoplastic processes, anatomical or structural disorders, and neuromuscular conditions. These diverse etiologies can result in both structural and functional deficits or neurological impairments that compromise swallowing function. While RDS frequently leads to uncommon conditions, dysphagia remains an underrecognized complication. Objectives: The primary objective of this review is to illuminate the latest knowledge concerning the management of dysphagia in both pediatric and adult populations within the context of RDS, with a particular focus on current therapeutic approaches. To achieve this, the study provides a comprehensive analysis of existing strategies for managing dysphagia in RDS, highlighting recent advancements in therapy while identifying critical gaps in clinical knowledge and practice. By synthesizing available evidence, the review aims to deepen understanding of the unique challenges associated with dysphagia in these conditions and explore innovative interventions to enhance patient care and outcomes. Results: The integration of innovative therapeutic techniques into the speech-language pathology treatment of dysphagia augments traditional strategies, offering updated knowledge that can be applied to prognosis and therapeutic interventions across various ages and racial groups. This review also provides an overview of symptomatology, assessment techniques, and the specific characteristics of dysphagia associated with various genetic and acquired RDS. Full article

Detecting and managing speech-language pathology symptoms in patients with post-COVID syndrome (long COVID) presents a significant challenge, as the condition is marked by persistent and varied symptoms such as cognitive deficits, communication difficulties, and voice disorders. To address these challenges, a Fuzzy Cognitive Map Decision Support System (FCM-DSS) was developed to model causal relationships and integrate expert knowledge. A systematic review approach, though not comprehensive, was utilized to identify key symptoms and their prevalence from 19 studies, focusing on brain fog, attention deficits, memory problems, dyspnea, and swallowing difficulties. The weighted prevalence of these symptoms informed the development of the FCM-DSS model, designed to link symptoms to medical specialties and recommend specialist referrals. Preliminary testing on four case studies demonstrated the tool’s potential, but further validation through pilot studies is necessary. Full article

The Inclusive Early Childhood Service System (IECSS) project is a longitudinal institutional ethnography that studies disability services in early childhood, and the interactions between these services and other systems, from the standpoint of families. In this paper, we examine speech-language services as part of a system of services and a site of participation for disabled children. We use longitudinal data from annual interviews with 117 informants to map Speech and Language services over the first six years of children’s lives. We report that speech and language pathology (SLP) as a professional discourse holds cultural significance and influences the organization of disabled children and their families. The analysis of the data illustrates the pervasiveness, organizational structure, and governance of speech and language pathology (SLP) in early childhood, leading to professional discourses of childhood and disability in early intervention, preschool, and school-based services which reinforce individualized pathology as the dominant way of understanding development. We discuss how the professional practices of SLP-related services could help to disrupt disabling constructs of childhood development and colonial practices in early childhood disability services. We emphasize how speech and language development emerges in relationship with individuals and socio-political contexts. We suggest possibilities for SLP to operate within community contexts where speech and language services contribute to reducing family workload, increasing the participation of all children, and disrupting ableism in practice. Full article

This conceptual paper critically examines the use of traditional medicalized terminology in speech-language therapy, with a particular focus on the Quebec context. It highlights how current language practices, rooted in a medical model of disability, often marginalize individuals with communication differences such as stuttering, autism, and aphasia by pathologizing these variations. Drawing on contemporary frameworks such as the social model of disability, neurodiversity, and “diversité capacitaire” (a French term that translates to “capacity diversity” or “ability diversity”, emphasizing the richness of diverse abilities and communication styles), the article advocates for more inclusive and empowering language that respects and reflects communicative diversity. The authors emphasize the importance of participatory approaches, including consultation with the communities directly involved and the establishment of terminological committees, to develop respectful and affirming language. Ultimately, this paper calls for a shift in speech-language therapy practices to promote a more inclusive understanding of communication, enabling individuals with communication differences to fully participate in society. Full article

Purpose: Speech-language pathologists (SLPs) are essential in evaluating tongue structure and function. Due to limited psychometrically validated assessment tools, evidence-based practitioners often rely on clinical expertise to inform their assessment and clinical decision-making. This study aimed to explore how SLPs assess tongue structure and function in children aged 1 to 10 years suspected of having a tongue-tie by examining global practice patterns. Methods: A total of 194 practicing, English-speaking SLPs participated in a global online survey. The survey gathered information on participant demographics, classification tools used, and methods for assessing tongue structure and function, oral motor function and speech production in children with suspected tongue-tie. Results: Participants reported using various measures, including case history, oral examination, and clinical assessment. These measures encompassed evaluation of tongue structure, oral motor tasks and functional measures, including observation of speech, feeding, and swallowing. Notably, 40% of participants indicated they did not use any published assessment tool. While over 90% of participants evaluated feeding skills through parent questionnaires, only 55% observed feeding during mealtimes. Additionally, SLPs in the United States reported using different classification tools for tongue-tie compared to their counterparts in Australia, the United Kingdom and other countries. Conclusion: There is a global trend of limited use of published tongue-tie assessment tools in clinical practice. Most clinicians rely on various measures to evaluate tongue structure and function in children with suspected tongue-tie. These findings highlight the need for a specialized assessment tool that is designed and validated for evaluating tongue structure and function in children beyond infancy. Full article

As artificial intelligence (AI) makes significant headway in various arenas, the field of speech–language pathology is at the precipice of experiencing a transformative shift towards automation. This study introduces QuickPic AAC, an AI-driven application designed to generate topic-specific displays from photographs in a “just-in-time” manner. Using QuickPic AAC, this study aimed to (a) determine which of two AI algorithms (NLG-AAC and GPT-3.5) results in greater specificity of vocabulary (i.e., percentage of vocabulary kept/deleted by clinician relative to vocabulary generated by QuickPic AAC; percentage of vocabulary modified); and to (b) evaluate perceived usability of QuickPic AAC among practicing speech–language pathologists. Results revealed that the GPT-3.5 algorithm consistently resulted in greater specificity of vocabulary and that speech–language pathologists expressed high user satisfaction for the QuickPic AAC application. These results support continued study of the implementation of QuickPic AAC in clinical practice and demonstrate the possibility of utilizing topic-specific displays as just-in-time supports. Full article

Objectives: To determine whether allied health interventions delivered using telehealth provide similar or better outcomes for patients compared with traditional face-to-face delivery modes. Study design: A rapid systematic review using the Cochrane methodology to extract eligible randomized trials. Eligible trials: Trials were eligible for inclusion if they compared a comparable dose of face-to-face to telehealth interventions delivered by a neuropsychologist, occupational therapist, physiotherapist, podiatrist, psychologist, and/or speech pathologist; reported patient-level outcomes; and included adult participants. Data sources: MEDLINE, CENTRAL, CINAHL, and EMBASE databases were first searched from inception for systematic reviews and eligible trials were extracted from these systematic reviews. These databases were then searched for randomized clinical trials published after the date of the most recent systematic review search in each discipline (2017). The reference lists of included trials were also hand-searched to identify potentially missed trials. The risk of bias was assessed using the Cochrane Risk of Bias Tool Version 1. Data Synthesis: Fifty-two trials (62 reports, n = 4470) met the inclusion criteria. Populations included adults with musculoskeletal conditions, stroke, post-traumatic stress disorder, depression, and/or pain. Synchronous and asynchronous telehealth approaches were used with varied modalities that included telephone, videoconferencing, apps, web portals, and remote monitoring, Overall, telehealth delivered similar improvements to face-to-face interventions for knee range, Health-Related Quality of Life, pain, language function, depression, anxiety, and Post-Traumatic Stress Disorder. This meta-analysis was limited for some outcomes and disciplines such as occupational therapy and speech pathology. Telehealth was safe and similar levels of satisfaction and adherence were found across modes of delivery and disciplines compared to face-to-face interventions. Conclusions: Many allied health interventions are equally as effective as face-to-face when delivered via telehealth. Incorporating telehealth into models of care may afford greater access to allied health professionals, however further comparative research is still required. In particular, significant gaps exist in our understanding of the efficacy of telehealth from podiatrists, occupational therapists, speech pathologists, and neuropsychologists. Protocol Registration Number: PROSPERO (CRD42020203128). Full article