American Journal of Speech-Language Pathology recent issues

More Than Just Talk [From the Editor]

Hammer, C. S. — 2012-02-03T09:45:10-08:00

Vocal Fold Phase Asymmetries in Patients With Voice Disorders: A Study Across Visualization Techniques [Research]

Bonilha, H. S., Deliyski, D. D., Whiteside, J. P., Gerlach, T. T. — 2012-02-03T09:45:10-08:00

Purpose

To examine differences in vocal fold vibratory phase asymmetry judged from stroboscopy, high-speed videoendoscopy (HSV), and the HSV-derived playbacks of mucosal wave kymography, digital kymography, and a static medial digital kymography image of persons with hypofunctional and hyperfunctional voice disorders. Differences between the methods of visual judgments and objective measures of left-right phase asymmetry were assessed. The findings were compared with those from a previous study with vocally normal speakers.

Method

Forty-nine persons with voice disorders underwent stroboscopy and HSV. The HSV images were processed, resulting in 4 different spatial or kymographic displays. Two types of phase asymmetries, left-right and anterior-posterior, were visually rated. Objective measures of left-right phase asymmetry were obtained.

Results

From stroboscopy, the HSV playback, and the HSV-derived playbacks, left-right phase symmetry was judged to be symmetrical in 41%, 32%, and 19% of cases, respectively. This difference in playbacks was not seen for anterior-posterior asymmetry. Correlation between visual judgments and objective measures was mild for stroboscopy and moderate to high for all HSV-based playbacks.

Conclusions

The use of kymography appears important for judgments of phase asymmetry. Stroboscopy appears to be sensitive, but possibly not specific, to phase asymmetries. Further development of objective measures is warranted for this feature.

Development of the Communication Complexity Scale [Research Article]

2012-02-03T09:45:10-08:00

Purpose

Accurate description of an individual's communication status is critical in both research and practice. Describing the communication status of individuals with severe intellectual and developmental disabilities is difficult because these individuals often communicate with presymbolic means that may not be readily recognized. Our goal was to design a communication scale and summary score for interpretation that could be applied across populations of children and adults with limited (often presymbolic) communication forms.

Method

The Communication Complexity Scale (CCS) was developed by a team of researchers and tested with 178 participants with varying levels of presymbolic and early symbolic communication skills. Correlations between standardized and informant measures were completed, and expert opinions were obtained regarding the CCS.

Results

CCS scores were within expected ranges for the populations studied, and interrater reliability was high. Comparison across other measures indicated significant correlations with standardized tests of language. Scores on informant report measures tended to place children at higher levels of communication. Expert opinions generally favored the development of the CCS.

Conclusions

The scale appears to be useful for describing a given individual's level of presymbolic or early symbolic communication. Further research is needed to determine whether it is sensitive to developmental growth in communication.

Macrostructural Narrative Language of Adolescents and Young Adults With Down Syndrome or Fragile X Syndrome [Research Article]

Finestack, L. H., Palmer, M., Abbeduto, L. — 2012-02-03T09:45:10-08:00

Purpose

To gain a better understanding of language abilities, the expressive macrostructural narrative language abilities of verbally expressive adolescents and young adults with Down syndrome (DS) and those with fragile X syndrome (FXS) were examined.

Method

The authors evaluated 24 adolescents and young adults with DS, 12 male adolescents and young adults with FXS, and 21 younger children with typical development (TD). Narrative samples were assessed at the macrostructural level using the narrative scoring scheme (Heilmann, Miller, Nockerts, & Dunaway, 2010). Three group comparisons were made using (a) the full sample matched on nonverbal mental age, (b) a subset of the participants individually matched on nonverbal mental age, and (c) a subset of participants individually matched on mean length of utterance.

Results

Study analyses revealed that the DS and FXS groups significantly outperformed the TD group on a limited number of narrative scoring scheme measures. No significant differences emerged between the DS and FXS groups.

Conclusions

The study's results suggest that some aspects of macrostructural narrative language may be relative strengths for adolescents and young adults with DS and those with FXS. These results can be used to create more nuanced and informed approaches to assessment and intervention for these populations.

Facilitating Emergent Literacy: Efficacy of a Model That Partners Speech-Language Pathologists and Educators [Research Article]

Girolametto, L., Weitzman, E., Greenberg, J. — 2012-02-03T09:45:10-08:00

Purpose

This study examined the efficacy of a professional development program for early childhood educators that facilitated emergent literacy skills in preschoolers. The program, led by a speech-language pathologist, focused on teaching alphabet knowledge, print concepts, sound awareness, and decontextualized oral language within naturally occurring classroom interactions.

Method

Twenty educators were randomly assigned to experimental and control groups. Educators each recruited 3 to 4 children from their classrooms to participate. The experimental group participated in 18 hr of group training and 3 individual coaching sessions with a speech-language pathologist. The effects of intervention were examined in 30 min of videotaped interaction, including storybook reading and a post-story writing activity.

Results

At posttest, educators in the experimental group used a higher rate of utterances that included print/sound references and decontextualized language than the control group. Similarly, the children in the experimental group used a significantly higher rate of utterances that included print/sound references and decontextualized language compared to the control group.

Conclusion

These findings suggest that professional development provided by a speech-language pathologist can yield short-term changes in the facilitation of emergent literacy skills in early childhood settings. Future research is needed to determine the impact of this program on the children's long-term development of conventional literacy skills.

Predictors of Second Language Acquisition in Latino Children With Specific Language Impairment [Research Article]

Gutierrez-Clellen, V., Simon-Cereijido, G., Sweet, M. — 2012-02-03T09:45:10-08:00

Purpose

This study evaluated the extent to which the language of intervention, the child's development in Spanish, and the effects of English vocabulary, use, proficiency, and exposure predict differences in the rates of acquisition of English in Latino children with specific language impairment (SLI).

Method

In this randomized controlled trial, 188 Latino preschoolers with SLI participated in a small-group academic enrichment program for 12 weeks and were followed up 3 and 5 months later. Children were randomly assigned to either a bilingual or an English-only program. Predictors of English growth included measures of Spanish language skills and English vocabulary, use, proficiency, and exposure. Performance on English outcomes (i.e., picture description and narrative sample) was assessed over time. A series of longitudinal models were tested via multilevel modeling with baseline and posttreatment measures nested within child.

Results

Children demonstrated growth on the English outcomes over time. The language of intervention, Spanish skills, English vocabulary, and English use significantly predicted differences in rates of growth across children for specific measures of English development.

Conclusions

This study underscores the role of the child's first language skills, the child's level of English vocabulary development, and level of English use for predicting differences in English acquisition in Latino preschoolers with SLI. These factors should be carefully considered in making clinical decisions.

Changing Nonmainstream American English Use and Early Reading Achievement From Kindergarten to First Grade [Research Article]

Terry, N. P., McDonald Connor, C. — 2012-02-03T09:45:10-08:00

Purpose

This study had 2 principal aims: (a) to examine whether children who spoke Nonmainstream American English (NMAE) frequently in school at the end of kindergarten increased their production of Mainstream American English (MAE) forms by the end of first grade, and (b) to examine concurrent and predictive relations between children's NMAE use and reading skills.

Method

A longitudinal design was implemented with 49 children who varied in their spoken NMAE production in kindergarten. Word reading, phonological awareness, and receptive vocabulary skills were measured at both time points.

Results

Analyses indicated that most children significantly increased their production of MAE forms between the 2 time points; however, this change was not associated with change in letter-word reading and phonological awareness skills. Regression analyses showed that NMAE use in kindergarten contributed significantly and independently to the variance in word reading in first grade, even after accounting for phonological awareness (although word reading in kindergarten was the best predictor of word reading in first grade).

Conclusions

The findings extend previous reports of a significant relation between NMAE use and reading among young children. Theoretical, research, and educational implications of the findings are discussed.

The Importance of Participant Demographics [From the Editor]

Hammer, C. S. — 2011-11-01T09:00:51-07:00

The Utility of Pitch Elevation in the Evaluation of Oropharyngeal Dysphagia: Preliminary Findings [Research Article]

Malandraki, G. A., Hind, J. A., Gangnon, R., Logemann, J. A., Robbins, J. — 2011-11-01T09:00:51-07:00

Purpose

To evaluate the utility of a pitch elevation task in the assessment of oropharyngeal dysphagia.

Method

This study was a pilot prospective cohort study including 40 consecutive patients (16 male and 24 female) who were referred by their physician for a swallowing evaluation. Patients were evaluated with a noninstrumental clinical examination and a videofluoroscopic swallow study, and participated in a pitch elevation task during videofluoroscopic image acquisition. Relationships between pitch elevation measurements (acoustic and perceptual) and swallow parameters (penetration/aspiration and residue) were investigated.

Results

Results of this pilot study revealed that both maximum fundamental frequency (F₀) and perceptual evaluation of pitch elevation independently significantly predicted Penetration-Aspiration Scale scores for thin liquid swallows (p = .01 and .03, respectively). Vocal range (average pitch to falsetto) was not sensitive in predicting likelihood of oropharyngeal dysphagia.

Conclusions

Findings indicate that reduced pitch elevation can be indicative of reduced airway protection and swallowing impairment in some dysphagia patients and may be a useful supplement to dysphagia screening and diagnosis. Further investigation is warranted to determine the optimal utility of this procedure for different diagnostic categories of patients.

A Qualitative Study of Interference With Communicative Participation Across Communication Disorders in Adults [Research Article]

Baylor, C., Burns, M., Eadie, T., Britton, D., Yorkston, K. — 2011-11-01T09:00:51-07:00

Purpose

To explore the similarities and differences in self-reported restrictions in communicative participation across different communication disorders in community-dwelling adults.

Method

Interviews were conducted with 44 adults representing 7 different medical conditions: spasmodic dysphonia, multiple sclerosis, stroke, stuttering, Parkinson's disease, amyotrophic lateral sclerosis, and laryngectomy. This article represents a secondary analysis of qualitative data collected in cognitive interviews during development of the Communicative Participation Item Bank. The data were analyzed to identify themes in participants' experiences related to communicative participation.

Results

Participants described many situations in which they experienced interference in communicative participation. Two themes emerged from the data. The first theme was Interference is both "functional" and "emotional," in which participants defined interference as limitations in accomplishing tasks and emotional consequences. The second theme was "It depends"—sources of interference, in which participants described many variables that contribute to interference in participation. Participants had limited control of some variables such as symptoms and environmental contexts, but personal decisions and priorities also influenced participation.

Conclusions

Despite different impairments and activity limitations, participants described similar communicative participation restrictions. These similarities may have theoretical and clinical implications in terms of how we assess, treat, and study the participation restrictions associated with communication disorders.

Facilitating Children's Ability to Distinguish Symbols for Emotions: The Effects of Background Color Cues and Spatial Arrangement of Symbols on Accuracy and Speed of Search [Research Article]

Wilkinson, K. M., Snell, J. — 2011-11-01T09:00:51-07:00

Purpose

Communication about feelings is a core element of human interaction. Aided augmentative and alternative communication systems must therefore include symbols representing these concepts. The symbols must be readily distinguishable in order for users to communicate effectively. However, emotions are represented within most systems by schematic faces in which subtle distinctions are difficult to represent. We examined whether background color cuing and spatial arrangement might help children identify symbols for different emotions.

Method

Thirty nondisabled children searched for symbols representing emotions within an 8-choice array. On some trials, a color cue signaled the valence of the emotion (positive vs. negative). Additionally, the symbols were either (a) organized with the negatively valenced symbols at the top and the positive symbols on the bottom of the display or (b) distributed randomly throughout. Dependent variables were accuracy and speed of responses.

Results

The speed with which children could locate a target was significantly faster for displays in which symbols were clustered by valence, but only when the symbols had white backgrounds. Addition of a background color cue did not facilitate responses.

Conclusions

Rapid search was facilitated by a spatial organization cue, but not by the addition of background color. Further examination of the situations in which color cues may be useful is warranted.

Risk for Poor Performance on a Language Screening Measure for Bilingual Preschoolers and Kindergarteners [Research Article]

Pena, E. D., Gillam, R. B., Bedore, L. M., Bohman, T. M. — 2011-11-01T09:00:51-07:00

Purpose

This study documents the risk for language impairment in Latino children who had different levels of exposure to English and Spanish.

Method

A total of 1,029 preschool- and kindergarten-age children were screened in the domains of semantics and morphosyntax in both Spanish and English. Parent report was used to document current exposure to and use of Spanish and English, as well as year of first exposure to English. Risk for language impairment was compared for language group, year of first English exposure, age, and mother's education.

Results

While bilingual children's scores on each subtest were significantly lower compared to their functional monolingual peers, they were no more likely to fall in the at-risk range based on a combination of all 4 subtests. Maternal education and year of first English exposure were weakly associated with risk for language impairment but not with language group (via 5 levels of first and second language exposure).

Conclusions

Prevalence of risk for language impairment when both languages are tested is not related to language group.

The Impact of Teacher Responsivity Education on Preschoolers' Language and Literacy Skills [Research Article]

2011-11-01T09:00:51-07:00

Purpose

This study examined the extent to which teacher responsivity education affected preschoolers' language and literacy development over an academic year. Additional aims were to determine whether children's initial language abilities and teachers' use of responsivity strategies were associated with language outcomes, in particular.

Method

In this randomized controlled trial, preschool centers were assigned to a responsivity education intervention (n = 19 centers, 25 teachers, and 174 children) or a "business-as-usual" control condition (n = 19 centers, 24 teachers, and 156 children). Teachers within the intervention centers received training focused on a set of strategies designed to promote children's engagement and participation in extended conversational interactions across the school day.

Results

Hierarchical linear models showed no main effects on children's language skills, although moderating effects were observed such that the intervention appeared to have positive effects for children with relatively high initial language abilities. In addition, teacher use of responsivity strategies was positively associated with vocabulary development. With regard to children's literacy skills, there was a significant main effect of the intervention on print-concept knowledge.

Conclusions

Although teacher responsivity education is viewed as benefitting children's language and literacy development, the impacts of this type of intervention on children's skills warrant further investigation.

Clinical Experience Using the Mann Assessment of Swallowing Ability for Identification of Patients at Risk for Aspiration in a Mixed-Disease Population [Research Note]

Gonzalez-Fernandez, M., Sein, M. T., Palmer, J. B. — 2011-11-01T09:00:51-07:00

Purpose

To determine the clinical performance characteristics of the Mann Assessment of Swallowing Ability (MASA) for predicting aspiration (determined by videofluoroscopic swallowing study [VFSS]) in a mixed population.

Method

We selected 133 cases clinically evaluated using MASA and VFSS from January through June 2007. Ordinal risk rating (ORR) and total numeric score (TNS) were evaluated as predictors of aspiration on VFSS. To account for missing items, the maximum possible score was determined and a weighted percentage score calculated for each patient. We used receiver operating characteristic (ROC) analysis to compare the sensitivity and specificity of ORR and TNS for predicting aspiration.

Results

VFSS identified 51 (38.4%) aspirators, while ORR identified 54 (40.6%) as probable or definite aspiration and TNS 19 (14.3%) as moderate to severe aspiration risk. ROC analysis demonstrated an area under the curve of 0.74, 95% CI [0.66, 0.82], for ORR and 0.51, 95% CI [0.41, 0.61], for TNS. These ROC scores suggest that the MASA ORR is better at predicting aspiration on VFSS than the numeric score.

Conclusion

In this sample, the subjective ORR had good predictive ability, while the percentage TNS failed to predict aspiration on VFSS. The MASA ORR assessment was a better predictor for a patient's aspiration risk in this population.

Language in the Cerebellum [Review]

Highnam, C. L., Bleile, K. M. — 2011-11-01T09:00:51-07:00

Purpose

To explore increasingly compelling evidence that the adult human cerebellum is involved in nonmotor affective and cognitive activity, including language—functions that have in the past been associated largely with the limbic system and the cerebral cortex.

Method

We review clinical studies of patients with cerebellar lesions, nonclinical neuroimaging studies of individuals engaged in completing selected tasks, and neuroanatomical as well as neuroimaging studies of brain interconnections. In the course of this review, we also report on a variety of hypotheses regarding the nature of the cerebellum's work in affective processing and language/cognition.

Results

This review suggests that the cerebellum has considerable influence in language processing and other related higher level affective/cognitive activities.

Conclusion

We conclude with a preliminary list of important clinical implications of these results.

Assessment of Phonation Threshold Pressure: A Critical Review and Clinical Implications [Review]

Plexico, L. W., Sandage, M. J., Faver, K. Y. — 2011-11-01T09:00:51-07:00

Purpose

To describe the origins of the task elicitation procedure for determining phonation threshold pressure and, through a literature review and online survey, describe published procedural, environmental, and participant variable departures from the original methodology.

Method

Literature search terms included phonation threshold pressure, subglottal pressure and phonation, pressure measurement and phonation, lung pressure and phonation, and vocal fold oscillation onset. Inclusion criteria were limited to indirect assessment of phonation threshold pressure, English language publications between 1980 and 2009, and peer-reviewed journals. Studies including animals, computer or physical models, alaryngeal speakers, laryngeal airway resistance, or any airflow interruption technique were excluded. Twenty-four articles matched the inclusionary criteria. An online survey to query task elicitation procedures was then developed from the literature review.

Results

The scientific rationale for inclusion of phonation threshold pressure data was consistent across published studies; however, variations in procedural methodology for task elicitation were identified, as were environmental and participant inconsistencies that might affect phonation threshold pressure values. Findings of the online survey mirrored the inconsistencies identified in the literature review.

Conclusions

The methodological differences for task elicitation identified in this comprehensive review of the literature and the online survey, while bringing into question the reliability of phonation threshold pressure measurement, illuminate scientific questions yet to be answered to further refine and potentially standardize phonation threshold pressure as a more reliable research and clinical measurement.

Expanding Our Knowledge Base Through Qualitative Research Methods [From the Editor]

Scheffner Hammer, C. — 2011-08-01T09:00:45-07:00

Language Abilities of Children Who Stutter: A Meta-Analytical Review [Research]

Ntourou, K., Conture, E. G., Lipsey, M. W. — 2011-08-01T09:00:45-07:00

Purpose

To identify, integrate, and summarize evidence from empirical studies of the language abilities of children who stutter (CWS) and children who do not stutter (CWNS).

Method

Candidate studies were identified through electronic databases, the tables of contents of speech-language journals, and reference lists of relevant articles and literature reviews. The 22 included studies met the following criteria: studied both children who did and did not stutter between ages 2;0 (years;months) and 8;0, and reported norm-referenced language measures and/or measures from spontaneous language samples amenable to effect size calculation. Data were extracted using a coding manual and were assessed by application of general and specialized analytical software. Mean difference effect size was estimated using Hedges's g (Hedges, 1982).

Results

Findings indicated that CWS scored significantly lower than CWNS on norm-referenced measures of overall language (Hedges's g = –0.48), receptive (Hedges's g = –0.52) and expressive vocabulary (Hedges's g = –0.41), and mean length of utterance (Hedges's g = –0.23).

Conclusions

Present findings were taken to suggest that children's language abilities are potentially influential variables associated with childhood stuttering.

The Effectiveness of Parent-Implemented Language Interventions: A Meta-Analysis [Research Article]

Roberts, M. Y., Kaiser, A. P. — 2011-08-01T09:00:45-07:00

Purpose

The purpose of this meta-analysis was to systematically evaluate the effects of parent-implemented language interventions on the language skills of children between 18 and 60 months of age with primary and secondary language impairments.

Method

A systematic literature search yielded 18 studies that met the predetermined inclusion and exclusion criteria. Effect sizes for each study were calculated for 7 language outcome variables and analyzed using a random effects model. Separate analyses were conducted for each language outcome and for each comparison group. Outcomes were compared for children with and without intellectual disabilities and for parent report and direct observational language measures.

Results

The results indicate that parent-implemented language interventions have a significant, positive impact on receptive and expressive language skills of children with and without intellectual disabilities. Effect sizes (g) for child measures ranged from –0.15 to 0.82 depending on the outcome measure and comparison group.

Conclusion

The results of this review indicate that parent-implemented language interventions are an effective approach to early language intervention for young children with language impairments. Critical features of parent-implemented interventions are discussed in terms of implications for practice and future research.

Using the Preschool Language Scale, Fourth Edition to Characterize Language in Preschoolers With Autism Spectrum Disorders [Research Article]

2011-08-01T09:00:45-07:00

Purpose

The Preschool Language Scale, Fourth Edition (PLS–4; Zimmerman, Steiner, & Pond, 2002) was used to examine syntactic and semantic language skills in preschool children with autism spectrum disorders (ASD) to determine its suitability for use with this population. We expected that PLS–4 performance would be better in more intellectually able children and that receptive skills would be relatively more impaired than expressive abilities, consistent with previous findings in the area of vocabulary.

Method

Our sample consisted of 294 newly diagnosed preschool children with ASD. Children were assessed via a battery of developmental measures, including the PLS–4.

Results

As expected, PLS–4 scores were higher in more intellectually able children with ASD, and overall, expressive communication was higher than auditory comprehension. However, this overall advantage was not stable across nonverbal developmental levels. Expressive skills were significantly better than receptive skills at the youngest developmental levels, whereas the converse applied in children with more advanced development.

Conclusions

The PLS–4 can be used to obtain a general index of early syntax and semantic skill in young children with ASD. Longitudinal data will be necessary to determine how the developmental relationship between receptive and expressive language skills unfolds in children with ASD.

Effects of Length, Complexity, and Grammatical Correctness on Stuttering in Spanish-Speaking Preschool Children [Research Article]

Watson, J. B., Byrd, C. T., Carlo, E. J. — 2011-08-01T09:00:45-07:00

Purpose

To explore the effects of utterance length, syntactic complexity, and grammatical correctness on stuttering in the spontaneous speech of young, monolingual Spanish-speaking children.

Method

Spontaneous speech samples of 11 monolingual Spanish-speaking children who stuttered, ages 35 to 70 months, were examined. Mean number of syllables, total number of clauses, utterance complexity (i.e., containing no clauses, simple clauses, or subordinate and/or conjoined clauses), and grammatical correctness (i.e., the presence or absence of morphological and syntactical errors) in stuttered and fluent utterances were compared.

Results

Findings revealed that stuttered utterances in Spanish tended to be longer and more often grammatically incorrect, and contain more clauses, including more subordinate and/or conjoined clauses. However, when controlling for the interrelatedness of syllable number and clause number and complexity, only utterance length and grammatical incorrectness were significant predictors of stuttering in the spontaneous speech of these Spanish-speaking children. Use of complex utterances did not appear to contribute to the prediction of stuttering when controlling for utterance length.

Conclusions

Results from the present study were consistent with many earlier reports of English-speaking children. Both length and grammatical factors appear to affect stuttering in Spanish-speaking children. Grammatical errors, however, served as the greatest predictor of stuttering.

Anxiety and Stuttering: Continuing to Explore a Complex Relationship [Review]

Iverach, L., Menzies, R. G., O'Brian, S., Packman, A., Onslow, M. — 2011-08-01T09:00:45-07:00

Purpose

The relationship between anxiety and stuttering has been widely studied. However, a review conducted more than 10 years ago (Menzies, Onslow, & Packman, 1999) identified 5 methodological issues thought to preclude consistent research findings regarding the nature of this relationship. The purpose of the present review was to determine whether methodological improvements have occurred since the Menzies et al. (1999) review.

Method

Literature published since the Menzies et al. review was evaluated with regard to the 5 methodological issues identified in that review: (a) the construct of anxiety, (b) trait anxiety measures, (c) participant numbers, (d) treatment status of participants, and (e) speaking tasks.

Results

Despite some remaining ambiguous findings, research published since the Menzies et al. review has provided far stronger evidence of a relationship between stuttering and anxiety, and has focused more on social anxiety, expectancies of social harm, and fear of negative evaluation.

Conclusion

The aims of future research should be to improve research design, increase statistical power, employ multidimensional measures of anxiety, and further develop anxiolytic treatment options for people who stutter.

Statistical, Practical, Clinical, and Personal Significance: Definitions and Applications in Speech-Language Pathology [Tutorial]

Bothe, A. K., Richardson, J. D. — 2011-08-01T09:00:45-07:00

Purpose

To discuss constructs and methods related to assessing the magnitude and the meaning of clinical outcomes, with a focus on applications in speech-language pathology.

Method

Professionals in medicine, allied health, psychology, education, and many other fields have long been concerned with issues referred to variously as practical significance, clinical significance, social validity, patient satisfaction, treatment effectiveness, or the meaningfulness or importance of beyond-clinic or real-world treatment outcomes. Existing literature addressing these issues from multiple disciplines was reviewed and synthesized.

Conclusions

Practical significance, an adjunct to statistical significance, refers to the magnitude of a change or a difference between groups. The appropriate existing term for the interpretation of treatment outcomes, or the attribution of meaning or value to treatment outcomes, is clinical significance. To further distinguish between important constructs, the authors suggest incorporating as definitive the existing notion that clinical significance may refer to measures selected or interpreted by professionals or with respect to groups of clients. The term personal significance is introduced to refer to goals, variables, measures, and changes that are of demonstrated value to individual clients.

An Introduction to Item Response Theory and Rasch Models for Speech-Language Pathologists [Tutorial]

Baylor, C., Hula, W., Donovan, N. J., Doyle, P. J., Kendall, D., Yorkston, K. — 2011-08-01T09:00:45-07:00

Purpose

To present a primarily conceptual introduction to item response theory (IRT) and Rasch models for speech-language pathologists (SLPs).

Method

This tutorial introduces SLPs to basic concepts and terminology related to IRT as well as the most common IRT models. The article then continues with an overview of how instruments are developed using IRT and some basic principles of adaptive testing.

Conclusion

IRT is a set of statistical methods that are increasingly used for developing instruments in speech-language pathology. While IRT is not new, its application in speech-language pathology to date has been relatively limited in scope. Several new IRT-based instruments are currently emerging. IRT differs from traditional methods for test development, typically referred to as classical test theory (CTT), in several theoretical and practical ways. Administration, scoring, and interpretation of IRT instruments are different from methods used for most traditional CTT instruments. SLPs will need to understand the basic concepts of IRT instruments to use these tools in their clinical and research work. This article provides an introduction to IRT concepts drawing on examples from speech-language pathology.