American Journal of Speech-Language Pathology recent issues

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.

Increasing Your Statistical Edge: Dealing With Nested Data Structures [From the Editor]

Justice, L. — Wed, 29 Jul 2009 15:11:17 PDT

Using Family Paradigms to Improve Evidence-Based Practice [Viewpoint]

Hidecker, M. J. C., Jones, R. S., Imig, D. R., Villarruel, F. A. — Wed, 29 Jul 2009 15:11:17 PDT

Purpose

Evidence-based practice (EBP) describes clinical decision making using research, clinical experience, and client values. For family-centered practices, the client's family is integral to this process. This article proposes that using family paradigms, a family science framework, may help elicit and understand client/family values within family-centered EBP.

Method

This article describes the family paradigms framework: 4 classic paradigms of "closed," "random," "open," and "synchronous." Its applicability to family-centered EBP is proposed using augmentative and alternative communication examples.

Results

A family-centered approach to EBP requires families to be an integral part of clinical decision making, but some families may need assistance in enumerating their views and values. Family paradigms (which consider how a family uses its resources of time, space, energy, and material in the pursuit of its goals of control, affect, meaning, and content) may be a way to elicit family values and preferences relevant to clinical decisions.

Conclusions

Family and client values can be incorporated throughout the EBP steps. Considering family paradigms may increase awareness and understanding of how families' views of their goals and resources affect clinical decisions. Further research is needed into both the processes and effectiveness of using family paradigms to conduct family-centered EBP.

Feeding Tube Placement in Patients With Advanced Dementia: The Beliefs and Practice Patterns of Speech-Language Pathologists [Research]

Sharp, H. M., Shega, J. W. — Wed, 29 Jul 2009 15:11:17 PDT

Purpose

To describe the beliefs and practices of speech-language pathologists (SLPs) about the use of percutaneous endoscopic gastrostomy (PEG) among patients with advanced dementia and dysphagia.

Method

A survey was mailed to a geographically stratified random sample of 1,050 medical SLPs.

Results

The response rate was 57%, and 326 surveys met inclusion criteria. Fifty-six percent of SLPs recommended PEG for a patient with advanced dementia and dysphagia. Contrary to the evidence, many respondents believed that PEG improves nutritional status and increases survival. Relatively few SLPs believed that PEG improved patients' functional status or quality of life. Patient factors (e.g., age or prognosis) were more often identified as influences on recommendations for PEG than were extrinsic factors (e.g., cost). Nearly 40% believed that PEG was the standard of care, while 15% believed it should be. Very few SLPs (11%) would want a PEG themselves. Perceived standard of care was significantly related to both geographic region and population density (p < .05), but self-reported practices were not.

Conclusions

Discrepancies between SLPs' beliefs, the literature, and self-reported practices were observed. The findings suggest the need to connect the evidence base to clinical practice and to include SLPs in local and national discussions about end-of-life care protocols.

The Effects of Color Cues on Typically Developing Preschoolers' Speed of Locating a Target Line Drawing: Implications for Augmentative and Alternative Communication Display Design [Research]

Thistle, J. J., Wilkinson, K. — Wed, 29 Jul 2009 15:11:17 PDT

Purpose

This research examined how the presence of color in relation to a target within an augmentative and alternative communication array influenced the speed with which typically developing preschoolers located a target line drawing.

Method

Fifteen children over the age of 4 years (from 4;2 [years;months] to 5;4) and 15 children under the age of 4 years (2;10–3;11) participated. Participants were asked to find a target line drawing of foods (e.g., banana and tomato) among an array of 12. The reaction time of locating the target was measured across 4 conditions in which the foreground color and the background color of the line drawing were manipulated.

Results

For all participants, line drawings featuring foreground color provided greater advantages in the speed of locating the target compared with drawings featuring only background color. Younger participants demonstrated faster reaction times when color was limited to the foreground.

Conclusion

Clinicians should consider incorporating color in the foreground of the line drawing when constructing visual displays. Targets that contain only background color but no foreground color appear to have a negative effect on the speed with which younger children can locate a target. Further research is needed to determine the effects in children with disabilities.

Syntactic Development in Adolescents With a History of Language Impairments: A Follow-Up Investigation [Research]

Nippold, M. A., Mansfield, T. C., Billow, J. L., Tomblin, J. B. — Wed, 29 Jul 2009 15:11:17 PDT

Purpose

Syntactic development in adolescents was examined using a spoken discourse task and standardized testing. The primary goal was to determine whether adolescents with a history of language impairments would differ from those with a history of typical language development (TLD). This is a companion study to one that examined these same adolescents 2 years earlier (M. A. Nippold, T. C. Mansfield, J. L. Billow, & J. B. Tomblin, 2008).

Method

The participants were 15-year-old adolescents with a history of specific language impairment (SLI; n = 102), nonspecific language impairment (NLI; n = 77), or TLD (n = 247). A sample of spoken discourse was elicited using a Peer Conflict Resolution (PCR) task and analyzed for mean length of T-unit, clausal density, and subordinate clause use. In addition, 2 subtests from the Clinical Evaluation of Language Fundamentals, Third Edition (E. Semel, E. H. Wiig, & W. A. Secord, 1995), Concepts and Directions and Recalling Sentences, were administered.

Results

On the PCR task, the TLD group outperformed the SLI and NLI groups on mean length of T-unit, clausal density, and nominal clause use, and the TLD group outperformed the NLI group on relative clause use. On the standardized testing, the TLD group outperformed the SLI and NLI groups, and the SLI group outperformed the NLI group. Correlation coefficients calculated between the nonstandardized and standardized measures of syntax were statistically significant and positive.

Conclusions

Speech-language pathologists may wish to employ the PCR task to examine syntactic development in adolescents as a supplement to standardized testing.

Feasibility and Benefit of Parent Participation in a Program Emphasizing Preschool Child Language Development While Homeless [Research]

O'Neil-Pirozzi, T. M. — Wed, 29 Jul 2009 15:11:17 PDT

Purpose

This exploratory study examined the feasibility of homeless parents' participation in an intervention to increase use of facilitating language strategies during interactions with their preschool children while residing in family homeless shelters. This study also examined the intervention's impact on the parents' use of facilitating language strategies, regardless of parent performance on a single-word receptive vocabulary test.

Method

Using a prospective, pretest/posttest comparison group design, 12 parents were randomly assigned to a 4-session experimental group training emphasizing use of facilitating language utterances with children following vocabulary testing. Four parents were randomly assigned to a control group intervention.

Results

It was feasible for parents to participate in the intervention. Before the intervention, individual experimental group parents with poor test performance demonstrated relatively high use of facilitating language utterances. After the intervention, the experimental group increased use of facilitating language utterances during interactions with their children.

Conclusions

This exploratory study provides initial evidence that it is feasible for parents to participate in, and benefit from, a brief language-based group intervention while residing in family homeless shelters. Further study of language-based interventions for these at-risk families and of the possible impact of parent language functioning on intervention benefit is needed.

Peer Responses to Stuttering in the Preschool Setting [Research]

Langevin, M., Packman, A., Onslow, M. — Wed, 29 Jul 2009 15:11:17 PDT

Purpose

This study investigated peer responses to preschoolers' stuttering in preschool and sought to determine whether specific characteristics of participants' stuttering patterns elicited negative peer responses.

Method

Four outdoor free-play sessions of 4 preschoolers age 3–4 years who stutter were videotaped. Stutters were identified on transcripts of the play sessions. Peer responses to stuttered utterances were judged to be negative or neutral/positive. Thereafter, participants' stuttering behaviors, durations of stutters, and judgments of the meaningfulness of peer-directed stuttered utterances were analyzed.

Results

Between 71.4% and 100% of peer responses were judged to be neutral/positive. In the negative responses across 3 participants, peers were observed to react with confusion or to interrupt, mock, walk away from, or ignore the stuttered utterances. Utterances that elicited negative responses were typically meaningless and contained stutters that were behaviorally complex and/or of longer duration. Other social interaction difficulties also were observed—for example, difficulty leading peers in play, participating in pretend play, and resolving conflicts.

Conclusions

Results indicate that the majority of peer responses to stuttered utterances were neutral/positive; however, results also indicate that stuttering has the potential to elicit negative peer responses and affect other social interactions in preschool.

Identification of Children With Language Impairment: Investigating the Classification Accuracy of the MacArthur-Bates Communicative Development Inventories, Level III [Research]

Skarakis-Doyle, E., Campbell, W., Dempsey, L. — Wed, 29 Jul 2009 15:11:17 PDT

Purpose

This study tested the accuracy with which the MacArthur–Bates Communicative Development Inventories, Level III (CDI–III), a parent report measure of language ability, discriminated children with language impairment from those developing language typically.

Method

Parents of 58 children, 49 with typically developing language (age 30 to 42 months) and 9 with language impairment (age 31 to 45 months) completed the CDI–III, a 2-page questionnaire that includes 100 vocabulary items, 12 sentence pairs, and 12 questions regarding linguistic concepts.

Results

A discriminant analysis indicated that the CDI–III total score together with age classified children into language status groups with 96.6% accuracy overall. The corresponding likelihood ratios supported this strong level of accuracy, although precision may not be as high as indicated by broad confidence intervals.

Conclusions

Results of this study contribute to the accumulating evidence on the types of valid inferences that may be made from the CDI–III, specifically its classification accuracy. Further research should continue to investigate classification accuracy in larger samples with broader maternal education levels and with different types of language impairments. Additional research should also investigate the classification accuracy when the CDI–III is used in combination with other tests.

Evaluation of a Deductive Procedure to Teach Grammatical Inflections to Children With Language Impairment [Research]

Finestack, L. H., Fey, M. E. — Wed, 29 Jul 2009 15:11:18 PDT

Purpose

To evaluate the learning effects of a deductive language-teaching procedure when teaching a novel gender agreement verb inflection to children with language impairment.

Method

Thirty-two 6–8-year-old children with language impairment were randomly assigned to either a deductive (N = 16) or an inductive (N = 16) treatment group. In the deductive treatment, the examiner presented a rule guiding the novel inflection to be learned as well as models of the inflection. In the inductive treatment, only models of the verb inflection were presented. Learning was assessed in 3 different production contexts during each of 4 treatment sessions.

Results

Significantly more participants in the deductive group than the inductive group acquired the novel morpheme based on a teaching probe (10 vs. 3), generalization probe (10 vs. 3), and maintenance probe (7 vs. 2). Task performance was not significantly influenced by language ability or nonverbal intelligence.

Conclusions

The deductive teaching procedure was found to be efficacious when teaching a novel grammatical inflection. However, this effect was limited because treatment gains varied across participants, testing contexts, and sessions. Future studies should continue to examine the efficacy of deductive procedures when integrated into traditional implicit approaches for children with language impairment.

Change [From the Editor]

Justice, L. — Fri, 01 May 2009 10:38:28 PDT

Is Expressive Language Disorder an Accurate Diagnostic Category? [Viewpoint]

Leonard, L. B. — Fri, 01 May 2009 10:38:28 PDT

Purpose

To propose that the diagnostic category of "expressive language disorder" as distinct from a disorder of both expressive and receptive language might not be accurate.

Method

Evidence that casts doubt on a pure form of this disorder is reviewed from several sources, including the literature on genetic findings, theories of language impairments, and the outcomes of late talkers with expressive language delays. Areas of language that are problematic in production but not readily amenable to comprehension testing are also discussed.

Conclusions

The notion of expressive language disorder has been formalized in classification systems and is implicit if not explicit in the organization of many standardized tests. However, a close inspection of the evidence suggests that deficits in language expression are typically accompanied by limitations in language knowledge or difficulties processing language input. For this reason, the diagnostic category of expressive language disorder should be used with considerable caution. This view has implications for both research and clinical practice.

Consensus Auditory-Perceptual Evaluation of Voice: Development of a Standardized Clinical Protocol [Clinical Focus]

Fri, 01 May 2009 10:38:28 PDT

Purpose

This article presents the development of the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) following a consensus conference on perceptual voice quality measurement sponsored by the American Speech-Language-Hearing Association's Special Interest Division 3, Voice and Voice Disorders. The CAPE-V protocol and recording form were designed to promote a standardized approach to evaluating and documenting auditory-perceptual judgments of vocal quality.

Method

A summary of the consensus conference proceedings and the factors considered by the authors in developing this instrument are included.

Conclusion

The CAPE-V form and instructions, included as appendices to this article, enable clinicians to document perceived voice quality deviations following a standard (i.e., consistent and specified) protocol.

When "Simon Says" Doesn't Work: Alternatives to Imitation for Facilitating Early Speech Development [Clinical Focus]

DeThorne, L. S., Johnson, C. J., Walder, L., Mahurin-Smith, J. — Fri, 01 May 2009 10:38:28 PDT

Purpose

To provide clinicians with evidence-based strategies to facilitate early speech development in young children who are not readily imitating sounds. Relevant populations may include, but are not limited to, children with autism spectrum disorders, childhood apraxia of speech, and late-talking toddlers.

Method

Through multifaceted search procedures, we found experimental support for 6 treatment strategies that have been used to facilitate speech development in young children with developmental disabilities. Each strategy is highlighted within this article through a summary of the underlying rationale(s), empirical support, and specific examples of how it could be applied within intervention.

Conclusions

Given the relatively sparse experimental data focused on facilitating speech in children who do not readily imitate, theoretical support emerges as particularly key and underscores the need for clinicians to consider why they are doing what they are doing. In addition, this review emphasizes the need for the research community to bridge the gap between pressing clinical needs and the limited evidence base that is currently available.

A Noninvasive Imaging Approach to Understanding Speech Changes Following Deep Brain Stimulation in Parkinson's Disease [Clinical Focus]

Fri, 01 May 2009 10:38:28 PDT

Purpose

To explore the use of noninvasive functional imaging and "virtual" lesion techniques to study the neural mechanisms underlying motor speech disorders in Parkinson's disease. Here, we report the use of positron emission tomography (PET) and transcranial magnetic stimulation (TMS) to explain exacerbated speech impairment following subthalamic nucleus deep brain stimulation (STN-DBS) in a patient with Parkinson's disease.

Method

Perceptual and acoustic speech measures, as well as cerebral blood flow during speech as measured by PET, were obtained with STN-DBS on and off. TMS was applied to a region in the speech motor network found to be abnormally active during DBS. Speech disruption by TMS was compared both perceptually and acoustically with speech produced with DBS on.

Results

Speech production was perceptually inferior and acoustically less contrastive during left STN stimulation compared to no stimulation. Increased neural activity in left dorsal premotor cortex (PMd) was observed during DBS on. "Virtual" lesioning of this region resulted in speech characterized by decreased speech segment duration, increased pause duration, and decreased intelligibility.

Conclusions

This case report provides evidence that impaired speech production accompanying STN-DBS may result from unintended activation of PMd. Clinical application of functional imaging and TMS may lead to optimizing the delivery of STN-DBS to improve outcomes for speech production as well as general motor abilities.

Fundamental Frequency Variation With an Electrolarynx Improves Speech Understanding: A Case Study [Research]

Watson, P. J., Schlauch, R. S. — Fri, 01 May 2009 10:38:29 PDT

Purpose

This study examined the effect of fundamental frequency (F0) variation on the intelligibility of speech in an alaryngeal talker who used an electrolarynx (EL).

Method

One experienced alaryngeal talker produced variable F0 and a constant F0 with his EL as he read sentences aloud. As a control, a group of sentences with variable F0 was flattened at a constant F0. Twenty listeners heard these sentences in background noise and wrote down what they heard.

Results

Speech understanding was on average 14% better with variable F0 controlled by the talker than the sentences produced with a constant F0 and the control sentences resynthesized with flattened F0.

Conclusions

Variable F0 contributes to speech understanding in noise. Because speech produced by an EL is considered to have poorer intelligibility in relation to other alaryngeal methods, training alaryngeal talkers to use variable F0 may prove to be of significant benefit for communication for those who use electrolarynges.

Effects of Robust Vocabulary Instruction and Multicultural Text on the Development of Word Knowledge Among African American Children [Research]

Lovelace, S., Stewart, S. R. — Fri, 01 May 2009 10:38:29 PDT

Purpose

To examine the effect of a systematic vocabulary instructional technique in African American 2nd-grade children with below average vocabulary skills. An additional goal was to examine the role of book type in the retention of novel vocabulary words.

Method

Using an adapted alternating treatments design, storybooks were used as a source for contextualizing vocabulary words in the context of robust vocabulary training. Five children's productive definitions were used to assess developing word knowledge using a 4-stage continuum ranging from no knowledge to full concept knowledge.

Results

Superior word learning for instruction words in comparison with control words replicated across children provided evidence of behavior change that was attributable to robust vocabulary instruction. Gains in word learning were maintained 2 weeks following conclusion of the study. Use of storybooks that displayed sociocultural images and experiences that were similar to versus different from their own did not have a reliable effect on word learning among these African American children.

Conclusions

The findings demonstrate the potential impact of robust vocabulary instruction for facilitating vocabulary development in children with below average vocabulary skills. Analysis of the results indicates that the use of the African American book was not a potent influence in facilitating retention of words.

Health Literacy and the Role of the Speech-Language Pathologist [Tutorial]

Hester, E. J., Stevens-Ratchford, R. — Fri, 01 May 2009 10:38:29 PDT

Purpose

This article reviews concepts of health literacy and discusses the role of speech-language pathologists in improving the health literacy of individuals with and without communication disorders.

Method

A literature review was completed of health literacy definitions, concepts, and health literacy assessment and intervention studies with various populations. A literature review was also conducted regarding health literacy or related studies in the field of speech-language pathology.

Conclusion

There is a paucity of information available on health literacy within the field of speech-language pathology. Suggestions are offered regarding increasing health literacy research and intervention by speech-language pathologists.

Establishing a Pedagogical Framework for the Multicultural Course in Communication Sciences and Disorders [Tutorial]

Horton-Ikard, R., Munoz, M. L., Thomas-Tate, S., Keller-Bell, Y. — Fri, 01 May 2009 10:38:29 PDT

Purpose

To provide an overview of a model for teaching a foundational course in multicultural (MC) issues and to demonstrate how it can be modified for use in communication sciences and disorders (CSD) by integrating 3 primary dimensions of cultural competence: awareness, knowledge, and skills.

Method

This tutorial begins by establishing the need for a basic foundational course in MC issues for CSD. Next, the authors describe a framework for MC instruction developed in the field of clinical counseling. Finally, the framework is modified and applied to the implementation of an MC course in CSD.

Conclusion

The MC course in CSD can provide a useful foundation for facilitating the cultural competence of students in university training programs that have infused MC material across the American Speech-Language-Hearing Association's 9 content areas.