American Journal of Speech-Language Pathology current issue

Don't Forget to Write [From the Editor]

Justice, L. — Sun, 01 Nov 2009 10:01:22 PST

Summary Publication Statistics for 2006-2008 [Editor's Report]

Sun, 01 Nov 2009 10:01:23 PST

Does Race/Ethnicity Really Matter in Adult Neurogenics? [Viewpoint]

Ellis, C. — Sun, 01 Nov 2009 10:01:23 PST

Purpose

Recent evidence suggests that race/ethnicity is a variable that is critical to outcomes in neurological disorders. The purpose of this article was to examine the proportion of studies published in the American Journal of Speech-Language Pathology (AJSLP) and the Journal of Speech, Language, and Hearing Research (JSLHR) that were designed to examine neurologically based disorders of communication in adults and that reported the race/ethnicity of the participants.

Method

A review of articles in AJSLP and JSLHR from 1997 through 2007 was completed to determine what proportion of articles in the area of adult neurogenic communication disorders reported the race/ethnicity of the participants.

Results

Between 1997 and 2007, less than 15% of the 116 articles published in the 2 journals reported the race/ethnicity of the participants. The review of studies indicates that the reporting of the race/ethnicity of participants in studies of adult neurogenic communication disorders remains inconsistent.

Conclusions

Because few studies report race/ethnicity or consider how race/ethnicity has the potential to confound the results and conclusions drawn, the generalization of the reported findings may be limited. Reporting race/ethnicity is likely critical to the external validity of studies in adult neurogenic communication disorders and when available can enhance the relevance of the findings reported.

The Use of Narratives to Identify Characteristics Leading to a Productive Life Following Acquired Brain Injury [Research]

Fraas, M. R., Calvert, M. — Sun, 01 Nov 2009 10:01:23 PST

Purpose

To determine the factors leading to successful recovery and productive lifestyles after acquired brain injury (ABI).

Method

Qualitative investigation examined semistructured interviews of 31 survivors of ABI. Thematic analysis followed a phenomenological approach and revealed 4 major themes and 28 subthemes in the interviews. Four participants stood out as exemplars of the themes embodied by all the participants in this investigation. Quotes from each are used to highlight the prevailing themes.

Results

The following 4 major themes emerged from the interviews: development of social support networks, grief and coping strategies, acceptance of the injury and redefinition of self, and empowerment.

Conclusions

The issues raised in these interviews may serve to inspire other survivors and provide them with hope and motivation as they progress through the recovery process. Suggestions on how clinicians can help to facilitate this process are discussed.

Validation of an Inventory of Best Practices in the Provision of Augmentative and Alternative Communication Services to Students With Severe Disabilities in General Education Classrooms [Research]

Calculator, S. N., Black, T. — Sun, 01 Nov 2009 10:01:23 PST

Purpose

To compile and then validate a set of evidence-based best practices related to augmentative and alternative communication (AAC) and its role in fostering the inclusion of students with severe disabilities in general education classrooms and other inclusive settings.

Method

A comprehensive review of the literature pertaining to AAC and inclusive education for students with severe disabilities in inclusive classrooms resulted in an inventory of possible best practices. Reliability testing was conducted to verify levels of evidence assigned to each source and corresponding practice. Practices were reviewed and validated by a panel of 8 experts. Statistical analysis revealed a high level of internal consistency across items composing the inventory.

Results

An inventory of 91 practices, each assigned to 1 of 8 predetermined categories, was uncovered. Themes arising in experts' comments related to items in the inventory are discussed.

Conclusions

Possible uses of the inventory are discussed along with suggestions for future research.

Evidence-Based Systematic Review: Effects of Nonspeech Oral Motor Exercises on Speech [Research]

McCauley, R. J., Strand, E., Lof, G. L., Schooling, T., Frymark, T. — Sun, 01 Nov 2009 10:01:23 PST

Purpose

The purpose of this systematic review was to examine the current evidence for the use of oral motor exercises (OMEs) on speech (i.e., speech physiology, speech production, and functional speech outcomes) as a means of supporting further research and clinicians' use of evidence-based practice.

Method

The peer-reviewed literature from 1960 to 2007 was searched for articles examining the use of OMEs to affect speech physiology, production, or functional outcomes (i.e., intelligibility). Articles that met selection criteria were appraised by 2 reviewers and vetted by a 3rd for methodological quality, then characterized as efficacy or exploratory studies.

Results

Fifteen studies met inclusion criteria; of these, 8 included data relevant to the effects of OMEs on speech physiology, 8 on speech production, and 8 on functional speech outcomes. Considerable variation was noted in the participants, interventions, and treatment schedules. The critical appraisals identified significant weaknesses in almost all studies.

Conclusions

Insufficient evidence to support or refute the use of OMEs to produce effects on speech was found in the research literature. Discussion is largely confined to a consideration of the need for more well-designed studies using well-described participant groups and alternative bases for evidence-based practice.

Evidence-Based Systematic Review: Effects of Neuromuscular Electrical Stimulation on Swallowing and Neural Activation [Research]

Clark, H., Lazarus, C., Arvedson, J., Schooling, T., Frymark, T. — Sun, 01 Nov 2009 10:01:23 PST

Purpose

To systematically review the literature examining the effects of neuromuscular electrical stimulation (NMES) on swallowing and neural activation. The review was conducted as part of a series examining the effects of oral motor exercises (OMEs) on speech, swallowing, and neural activation.

Method

A systematic search was conducted to identify relevant studies published in peer-reviewed journals from 1960 to 2007. All studies meeting the exclusion/inclusion criteria were appraised for quality and categorized as efficacy or exploratory research based on predetermined criteria.

Results

Out of 899 citations initially identified for the broad review of OMEs, 14 articles relating to NMES qualified for inclusion. Most of the studies (10/14) were considered exploratory research, and many had significant methodological limitations.

Conclusions

This systematic review reveals that surface NMES to the neck has been most extensively studied with promising findings, yet high-quality controlled trials are needed to provide evidence of efficacy. Surface NMES to the palate, faucial pillars, and pharynx has been explored in Phase I research, but no evidence of efficacy is currently available. Intramuscular NMES has been investigated in a single Phase I exploratory study. Additional research is needed to document the effects of such protocols on swallowing performance.

The Effects of Fast ForWord Language on the Phonemic Awareness and Reading Skills of School-Age Children With Language Impairments and Poor Reading Skills [Research]

Loeb, D. F., Gillam, R. B., Hoffman, L., Brandel, J., Marquis, J. — Sun, 01 Nov 2009 10:01:23 PST

Purpose

To examine the efficacy of Fast ForWord Language (FFW-L) and 2 other interventions for improving the phonemic awareness and reading skills of children with specific language impairment with concurrent poor reading skills.

Method

A total of 103 children (age 6;0 to 8;11 [years;months]) with language impairment and poor reading skills participated. The children received either FFW-L computerized intervention, a computer-assisted language intervention (CALI), an individualized language intervention (ILI), or an attention control (AC) computer program.

Results

The children in the FFW-L, CALI, and ILI conditions made significantly greater gains in blending sounds in words compared with the AC group at immediate posttest. Long-term gains 6 months after treatment were not significant but yielded a medium effect size for blending sounds in words. None of the interventions led to significant changes in reading skills.

Conclusion

The improvement in phonemic awareness, but not reading, in the FFW-L, CALI, and ILI interventions limits their use with children who have language impairment and poor reading skills. Similar results across treatment conditions suggest that acoustically modified speech was not a necessary component for improving phonemic awareness.

Transcribing the Speech of Children With Cochlear Implants: Clinical Application of Narrow Phonetic Transcriptions [Tutorial]

Teoh, A. P., Chin, S. B. — Sun, 01 Nov 2009 10:01:23 PST

Purpose

The phonological systems of children with cochlear implants may include segment inventories that contain both target and nontarget speech sounds. These children may not consistently follow phonological rules of the target language. These issues present a challenge for the clinical speech-language pathologist who uses phonetic transcriptions to evaluate speech production skills and to develop a plan of care. The purposes of this tutorial are to (a) identify issues associated with phonetic transcriptions of the speech of children with cochlear implants and (b) discuss implications for assessment.

Method

Narrow transcription data from an ongoing, longitudinal research study were catalogued and reviewed. Study participants had at least 5 years of cochlear implant experience and used spoken American English as a primary means of communication. In this tutorial, selected phonetic symbols and phonetic phenomena are reviewed.

Conclusions

A set of principles for phonetic transcriptions is proposed. Narrow phonetic transcriptions that include all segment possibilities in the International Phonetic Alphabet and extensions for disordered speech are needed to capture the subtleties of the speech of children with cochlear implants. Narrow transcriptions also may play a key role in planning treatment.