Speech and Hearing Sciences

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Abnormal patterns of tongue-palate contact in the speech of individuals with cleft palate
(Informa Healthcare, 2004-08) Gibbon, Fiona E.; Scottish Office Department of Health; Lloyds TSB Foundation for Scotland; MacRobert Trust, Scotland
Individuals with cleft palate, even those with adequate velopharyngeal function, are at high risk for disordered lingual articulation. This article attempts to summarize current knowledge of abnormal tongue-palate contact patterns derived from electropalatographic (EPG) data in speakers with cleft palate. These data, which have been reported in 23 articles published over the past 20 years, have added significantly to our knowledge about cleft palate speech. Eight abnormal patterns of tongue-palate contact are described and illustrated with data from children and adults with repaired cleft palate. The paper also discusses some of the problems in interpreting EPG data from speakers with abnormal craniofacial anatomy and emphasizes the importance of quantifying relevant aspects of tongue-palate contact data. Areas of research requiring further investigation are outlined.
Adult speakers' tongue-palate contact patterns for bilabial stops within complex clusters
(Taylor and Francis Ltd., 2009-12) Zharkova, Natalia; Schaeffler, Sonja; Gibbon, Fiona E.; London Law; Henry Smith Charity, United Kingdom
Previous studies using Electropalatography (EPG) have shown that individuals with speech disorders sometimes produce articulation errors that affect bilabial targets, but currently there is limited normative data available. In this study, EPG and acoustic data were recorded during complex word final /sps/ clusters spoken by 20 normal adults. A total contact (TC) index measured amount of tongue-palate contact during clusters in words such as 'crisps'. Bilabial closure was inferred from the acoustic signal. The TC profiles indicated that normal adults hold their tongues in a steady /s/-like position throughout the cluster; most speakers (85%, n=17) had no significant difference in TC values during bilabial closure compared to flanking fricatives. The results are interpreted as showing that normal speakers produce double bilabial-alveolar articulations for /p/ in these clusters. Although steady state TC profiles were typical of the group, absolute TC values varied considerably between speakers, with some speakers having up to three times more contact than others. These findings add to the knowledge about normal articulation, and will help to improve diagnosis and treatment of individuals with speech disorders.
Argument structure and specific language impairment: retrospect and prospect
(University of Groningen, 2014) de Jong, Jan; Fletcher, Paul
This article reflects a collaboration between the Universities of Groningen and Reading of which Frans Zwarts was the promoter. One of the outcomes was a close attention to the learning of various aspects of argument structure by children with specific language impairment (SLI) in Dutch and English. At that time and since, the focus on deficits in grammatical morphology in these children has left verb complementation as something of a syntactic Cinderella. Here we review the findings from our studies in the 1990s. We confirm that children with SLI in both languages have problems with verb specificity, with argument structure alternations and with resultative verb predicates. The very limited number of subsequent studies on verb syntax appear to support our findings. We conclude that this is an area which will repay further scrutiny – it is high time argument structure received an invitation to the ball.
Articulatory characteristics of the occlusion phase of /tS/ compared to /t/ in adult speech.
(Taylor and Francis, 2007-03) Liker, Marko; Gibbon, Fiona E.; Wrench, Alan; Horga, Damir
This study used electropalatography (EPG) to investigate articulatory characteristics of /tS/ and /t/ occlusion in order to provide normative data to be used for the diagnosis and treatment of individuals with speech disorders. EPG data from the EUR-ACCOR database were analysed for nonsense VCV sequences containing /tS/ and /t/ in nine vowel contexts for seven English speaking adults. The main results of this study are that all speakers had a significantly more posterior placement for /tS/ compared to /t/ and that placement was stable during the occlusion phase of both /tS/ and /t/. For most speakers, the occlusion phase was longer for /tS/ compared to /t/, the occlusion phase generally involved more EPG contact and was slightly more variable in /tS/ compared to /t/, but these differences were not statistically significant for all speakers. The implications of the results for diagnosing and treating speech disorders are discussed.
Assessing understanding of relative clauses: a comparison of multiple-choice comprehension versus sentence repetition
(Cambridge University Press, 2017-01-16) Frizelle, Pauline; O'Neill, Clodagh; Bishop, Dorothy V. M.
Although sentence repetition is considered a reliable measure of children's grammatical knowledge, few studies have directly compared children's sentence repetition performance with their understanding of grammatical structures. The current study aimed to compare children's performance on these two assessment measures, using a multiple-choice picture-matching sentence comprehension task and a sentence repetition task. Thirty-three typically developing children completed both assessments, which included relative clauses representing a range of syntactic roles. Results revealed a similar order of difficulty of constructions on both measures but little agreement between them when evaluating individual differences. Interestingly, repetition was the easier of the two measures, with children showing the ability to repeat sentences they did not understand. This discrepancy is primarily attributed to the additional processing load resulting from the design of multiple-choice comprehension tasks, and highlights the fact that these assessments are invoking skills beyond those of linguistic competence.
Assessment and treatment of short-term and working memory impairments in stroke aphasia - a practical tutorial
(John Wiley & Sons, Inc., 2015-06-30) Salis, Christos; Kelly, Helen; Code, Chris
Background: Aphasia following stroke refers to impairments that affect the comprehension and expression of spoken and/or written language, and co‐occurring cognitive deficits are common. In this paper we focus on short‐term and working memory impairments that impact on the ability to retain and manipulate auditory–verbal information. Evidence from diverse paradigms (large group studies, case studies) report close links between short‐term/working memory and language functioning in aphasia. This evidence leads to the hypothesis that treating such memory impairments would improve language functioning. This link has only recently been acknowledged in aphasia treatment but has not been embraced widely by clinicians. Aims: To examine the association between language, and short‐term and working memory impairments in aphasia. To describe practical ways of assessing short‐term and working memory functioning that could be used in clinical practice. To discuss and critically appraise treatments of short‐term and working memory reported in the literature. Methods & Procedures: Taking a translational research approach, this paper provides clinicians with current evidence from the literature and practical information on how to assess and treat short‐term and working memory impairments in people with aphasia. Published treatments of short‐term and/or working memory in post‐stroke aphasia are discussed through a narrative review. Main Contributions: This paper provides the following. A theoretical rationale for adopting short‐term and working memory treatments in aphasia. It highlights issues in differentially diagnosing between short‐term, working memory disorders and other concomitant impairments, e.g. apraxia of speech. It describes short‐term and working memory assessments with practical considerations for use with people with aphasia. It also offers a description of published treatments in terms of participants, treatments and outcomes. Finally, it critically appraises the current evidence base relating to the treatment of short‐term and working memory treatments. Conclusions: The links between short‐term/working memory functioning and language in aphasia are generally acknowledged. These strongly indicate the need to incorporate assessment of short‐term/working memory functioning for people with aphasia. While the supportive evidence for treatment is growing and appears to highlight the benefits of including short‐term/working memory in aphasia treatment, the quality of the evidence in its current state is poor. However, because of the clinical needs of people with aphasia and the prevalence of short‐term/working memory impairments, incorporating related treatments through practice‐based evidence is advocated.
Attention control comparisons with SLT for people with aphasia following stroke: methodological concerns raised following a systematic review
(SAGE Publications, 2018-06-17) Brady, Marian C.; Godwin, Jon; Kelly, Helen; Enderby, Pam; Elders, Andrew; Campbell, Pauline; Chief Scientist Office; Scottish Government Health and Social Care Directorate
Objective: Attention control comparisons in trials of stroke rehabilitation require care to minimize the risk of comparison choice bias. We compared the similarities and differences in SLT and social support control interventions for people with aphasia. Data sources: Trial data from the 2016 Cochrane systematic review of SLT for aphasia after stroke. Methods: Direct and indirect comparisons between SLT, social support and no therapy controls. We double-data extracted intervention details using the template for intervention description and replication. Standardized mean differences and risk ratios (95% confidence intervals (CIs)) were calculated. Results: Seven trials compared SLT with social support (n = 447). Interventions were matched in format, frequency, intensity, duration and dose. Procedures and materials were often shared across interventions. Social support providers received specialist training and support. Targeted language rehabilitation was only described in therapy interventions. Higher drop-out (P = 0.005, odds ratio (OR) 0.51, 95% CI 0.32–0.81) and non-adherence to social support interventions (P < 0.00001, OR 0.18, 95% CI 0.09–0.37) indicated an imbalance in completion rates increasing the risk of control comparison bias. Conclusion: Distinctions between social support and therapy interventions were eroded. Theoretically based language rehabilitation was the remaining difference in therapy interventions. Social support is an important adjunct to formal language rehabilitation. Therapists should continue to enable those close to the person with aphasia to provide tailored communication support, functional language stimulation and opportunities to apply rehabilitation gains. Systematic group differences in completion rates is a design-related risk of bias in outcomes observed.
Benchmarking typically developing children’s prosodic performance on the Irish version of the Profiling Elements of Prosody in Speech-Communication (PEPS-C)
(Irish Association of Speech and Language Therapists (IASLT); J&R Press Ltd., 2011) Foley, Michelle; Gibbon, Fiona E.; Peppé, Susan
Objective: To identify the normal prosodic performance for typically developing children aged 5-11 years on the Irish version of the Profiling Elements of Prosody in Speech Communication (PEPS-C) assessment and identify significant age related changes between different age groups. Method: Thirty typically developing children between the ages of 5;9 and 11;1 years completed the PEPS-C assessment which involved both receptive and expressive tasks. Results: Significant differences were found between the youngest group’s prosodic performance and the two older groups. The 5/6 year old age group performed less well than the 10/11 year age group (p<0.05). The 10/11 year age group performed above chance level on all prosodic tasks. Conclusion: While 5/6 year old children have acquired some functional prosodic skills, there are further developments between the ages of 5;9 and 9;5, with some aspects of prosody continuing to develop up to 11 years.
Bringing the outside in through facilitated communication technology in long term care: How do facilitated, virtual communication interventions influence peer interaction, social engagement and participant well-being?
(Irish Association for Applied Linguistics, 2021-06-11) Gleeson, Emma; Early, Elizabeth
This paper aims to report on a qualitative, pre- and post-intervention study in a long-term care (LTC) setting in Ireland. The focus of the study was to ascertain how a facilitated, virtual communication intervention, delivered once per week over a four-week period, influenced peer interaction and social engagement. Ten residents participated in semi-structured interviews before and after four weeks of once-per-week virtual talks delivered via an online platform. The interviews allowed to gain an insight into participant perceptions on the use of technology for engaging with topics of interest and facilitating social interaction in an accidental community. Interviews were transcribed and then analysed from a phenomenological perspective. Pre-intervention themes included ‘wellbeing in LTC’, ‘risks to wellbeing’, ‘social engagement’, ‘reminiscing about the past’, ‘curiosity’ and a ‘dearth of experience with technology’. Post-intervention interviews revealed themes including ‘a break from routine’, ‘forming new ties’, ‘technology for learning and wellbeing in long term care’, and its use to ‘augment personal choice and autonomy’ in such settings. Based on participants’ lived experience and the themes which emerged in the post-intervention interviews, there is potential for the facilitated use of technology to mitigate social isolation which can arise in such settings, and provide opportunities for common ground, choice-making and forming new ties.
CATALISE: A multinational and multidisciplinary Delphi consensus study. Identifying language impairments in children
(PLoS, 2016-07-08) Bishop, Dorothy V. M.; Snowling, Margaret J.; Thompson, Paul A.; Greenhalgh, Trisha; Catalise consortium; Wellcome Trust
Delayed or impaired language development is a common developmental concern, yet there is little agreement about the criteria used to identify and classify language impairments in children. Children's language difficulties are at the interface between education, medicine and the allied professions, who may all adopt different approaches to conceptualising them. Our goal in this study was to use an online Delphi technique to see whether it was possible to achieve consensus among professionals on appropriate criteria for identifying children who might benefit from specialist services. We recruited a panel of 59 experts representing ten disciplines (including education, psychology, speech-language therapy/pathology, paediatrics and child psychiatry) from English-speaking countries (Australia, Canada, Ireland, New Zealand, United Kingdom and USA). The starting point for round 1 was a set of 46 statements based on articles and commentaries in a special issue of a journal focusing on this topic. Panel members rated each statement for both relevance and validity on a seven-point scale, and added free text comments. These responses were synthesised by the first two authors, who then removed, combined or modified items with a view to improving consensus. The resulting set of statements was returned to the panel for a second evaluation (round 2). Consensus (percentage reporting 'agree' or 'strongly agree') was at least 80 percent for 24 of 27 round 2 statements, though many respondents qualified their response with written comments. These were again synthesised by the first two authors. The resulting consensus statement is reported here, with additional summary of relevant evidence, and a concluding commentary on residual disagreements and gaps in the evidence base.
Children’s comprehension of an unfamiliar speaker accent: a review
(John Wiley & Sons Ltd, 2016-01-27) Harte, Jennifer; Oliveira, Ana; Frizelle, Pauline; Gibbon, Fiona E.;
Background: The effect of speaker accent on listeners’ comprehension has become a key focus of research given the increasing cultural diversity of society and the increased likelihood of an individual encountering a clinician with an unfamiliar accent. Aims: To review the studies exploring the effect of an unfamiliar accent on language comprehension in typically developing (TD) children and in children with speech and language difficulties. This review provides a methodological analysis of the relevant studies by exploring the challenges facing this field of research and highlighting the current gaps in the literature. Methods & Procedures: A total of nine studies were identified using a systematic search and organized under studies investigating the effect of speaker accent on language comprehension in (1) TD children and (2) children with speech and/or language difficulties. Main Contribution: This review synthesizes the evidence that an unfamiliar speaker accent may lead to a breakdown in language comprehension in TD children and in children with speech difficulties. Moreover, it exposes the inconsistencies found in this field of research and highlights the lack of studies investigating the effect of speaker accent in children with language deficits. Conclusions & Implications: Overall, research points towards a developmental trend in children's ability to comprehend accent-related variations in speech. Vocabulary size, language exposure, exposure to different accents and adequate processing resources (e.g. attention) seem to play a key role in children's ability to understand unfamiliar accents. This review uncovered some inconsistencies in the literature that highlight the methodological issues that must be considered when conducting research in this field. It explores how such issues may be controlled in order to increase the validity and reliability of future research. Key clinical implications are also discussed.
Chinese communicative development inventories: user's guide and manual
(Peking University Medical Press, 2008) Tardif, Twila; Fletcher, Paul; Research Grants Council, University Grants Committee; Science Foundation Ireland
This Guide for users of the Cantonese and Putonghua (Mandarin) CDIs contains: an account of the standardisation projects undertaken in Hong Kong and Beijing for these parent report instruments; statistical information necessary to interpret the results of applying the CDIs; and, at the end of the book, all the parent report forms, for both languages, for short and long forms of the instruments. (For further statistical information on the long forms, visit wordbank.stanford.edu). The Chinese CDIs are modelled on the original MacArthur-Bates Communicative Development Inventories* but with appropriate adaptation for the cultural and linguistic characteristics of Putonghua and Cantonese. In common with the originals, they are designed to cover the age range from 8 – 30 months.
The co-construction of a reading assessment measure with adults with Down syndrome: a meaningful literacy approach
(Frontiers Media, 2023-07-20) Frizelle, Pauline; O’Donovan, Sean; Jolley, Mary; Martin, Lisa; Hart, Nicola
Introduction: The need to develop appropriate measures of broad-based reading-related literacy skills for adults with Down syndrome has been highlighted in the literature. In this study we aimed to co-construct a valid and reliable assessment measure that can be used to document meaningful everyday reading, in adolescents and adults with Down syndrome. Methods: The study was carried out in two stages. Stage 1 used an inclusive participatory design in which individuals with Down syndrome were research collaborators (n = 46). Items to be included in the measure were identified and ecological, face and content validity were established through an iterative process. In stage 2 we examined the reliability of the tool and explored potential relationships between meaningful reading score and (1) age, (2) receptive vocabulary, and (3) reading ability as measured by standardized assessments. In addition, we profiled what a pilot cohort of adults with Down syndrome read (n = 33) and how they experience reading in their everyday lives. Results: Results showed that 46 items were generated for inclusion in the Meaningful Reading Measure (MRM). Our preliminary data showed that the tool has internal and external reliability and ecological and content validity. There were no associations between meaningful reading score and any of the other variables examined. There was considerable variability in items read (range 12–44) which reflected a broad range of reading practices. Adults with Down syndrome identified the importance of reading as a pleasurable activity and as something that aids learning. Conclusion: The MRM developed here can be used (1) as a reading intervention outcome measure to complement existing standardized tools, (2) to profile meaningful reading in adults with Down syndrome, (3) to guide reading module content, and (4) to capture change in adults’ perceptions of themselves as readers. Future work is needed to establish the tool’s sensitivity to change over time.
Co-design of a feedback questionnaire for ICT-delivered aphasia rehabilitation
(Association for Computing Machinery (ACM), 2018-10) Kearns, Áine; Kelly, Helen; Pitt, Ian
Aphasia is an acquired loss or impairment of the language system that can occur after stroke. Information and Communication Technologies (ICT) can provide an option for the delivery of intensive aphasia rehabilitation but the usersâ views (i.e. people with aphasia) must be considered. There is no consensus measure of self-reported feedback in ICT-delivered aphasia rehabilitation and existing ICT usability questionnaires do not present questions in an accessible format for people with aphasia. This research employed a co-design process in which a group of adults with aphasia and the researchers collaborated in design workshops. The final product is an online feedback questionnaire that is accessible for people with aphasia. It provides relevant and meaningful self-reported feedback on participant engagement in ICT-delivered aphasia rehabilitation. This feedback is important when planning and monitoring aphasia rehabilitation.
A core outcome set for aphasia treatment research: the ROMA consensus statement
(SAGE Publications, 2018-10-10) Wallace, Sarah J.; Worrall, Linda; Rose, Tanya; Le Dorze, Guylaine; Breitenstein, Caterina; Hilari, Katerina; Babbitt, Edna; Bose, Arpita; Brady, Marian C.; Cherney, Leora R.; Copland, David; Cruice, Madeline; Enderby, Pam; Hersh, Deborah; Howe, Tami; Kelly, Helen; Kiran, Swathi; Laska, Ann-Charlotte; Marshall, Jane; Nicholas, Marjorie; Patterson, Janet; Pearl, Gill; Rochon, Elizabeth; Rose, Miranda; Sage, Karen; Small, Steven; Webster, Janet; British Aphasiology Society
Background: A core outcome set (COS; an agreed, minimum set of outcomes) was needed to address the heterogeneous measurement of outcomes in aphasia treatment research and to facilitate the production of transparent, meaningful, and efficient outcome data. Objective: The Research Outcome Measurement in Aphasia (ROMA) consensus statement provides evidence-based recommendations for the measurement of outcomes for adults with post-stroke aphasia within phases I–IV aphasia treatment studies. Methods: This statement was informed by a four-year program of research, which comprised investigation of stakeholder-important outcomes using consensus processes, a scoping review of aphasia outcome measurement instruments, and an international consensus meeting. This paper provides an overview of this process and presents the results and recommendations arising from the international consensus meeting. Results: Five essential outcome constructs were identified: Language, communication, patient-reported satisfaction with treatment and impact of treatment, emotional wellbeing, and quality of life. Consensus was reached for the following measurement instruments: Language: The Western Aphasia Battery Revised (WAB-R) (74% consensus); emotional wellbeing: General Health Questionnaire (GHQ)-12 (83% consensus); quality of life: Stroke and Aphasia Quality of Life Scale (SAQOL-39) (96% consensus). Consensus was unable to be reached for measures of communication (where multiple measures exist) or patient-reported satisfaction with treatment or impact of treatment (where no measures exist). Discussion: Harmonization of the ROMA COS with other core outcome initiatives in stroke rehabilitation is discussed. Ongoing research and consensus processes are outlined. Conclusion: The WAB-R, GHQ-12, and SAQOL-39 are recommended to be routinely included within phases I–IV aphasia treatment studies. This consensus statement has been endorsed by the Collaboration of Aphasia Trialists, the British Aphasiology Society, the German Society for Aphasia Research and Therapy, and the Royal College of Speech Language Therapists.
D4 Report on SHAFE policies, strategies and funding
(NET4Age-Friendly, 2021-11) van Staalduinen, Willeke; Spiru, Luiza; Illario, Maddalena; Dantas, Carina; Paul, Cosmina; Naselli , Fabio; Coman, Florina; European Cooperation in Science and Technology; Kelly, Helen
The objective of Working Group (WG) 4 of the COST Action NET4Age-Friendly is to examine existing policies, advocacy, and funding opportunities and to build up relations with policy makers and funding organisations. Also, to synthesize and improve existing knowledge and models to develop from effective business and evaluation models, as well as to guarantee quality and education, proper dissemination and ensure the future of the Action. The Working Group further aims to enable capacity building to improve interdisciplinary participation, to promote knowledge exchange and to foster a cross-European interdisciplinary research capacity, to improve cooperation and co-creation with cross-sectors stakeholders and to introduce and educate students SHAFE implementation and sustainability (CB01, CB03, CB04, CB05). To enable the achievement of the objectives of Working Group 4, the Leader of the Working Group, the Chair and Vice-Chair, in close cooperation with the Science Communication Coordinator, developed a template (see annex 1) to map the current state of SHAFE policies, funding opportunities and networking in the COST member countries of the Action. On invitation, the Working Group lead received contributions from 37 countries, in a total of 85 Action members. The contributions provide an overview of the diversity of SHAFE policies and opportunities in Europe and beyond. These were not edited or revised and are a result of the main areas of expertise and knowledge of the contributors; thus, gaps in areas or content are possible and these shall be further explored in the following works and reports of this WG. But this preliminary mapping is of huge importance to proceed with the WG activities.
Developing assessment tools for bilingual and minority language acquisition
(Irish Association of Speech and Language Therapists (IASLT); J&R Press Ltd., 2008) O'Toole, Ciara; Fletcher, Paul
Profiling bilingual and minority language acquisition is becoming increasingly important for the work of speech and language therapists in Ireland. The Official Language Act dictates that all government and public services must be provided in Irish as well as English. Therefore SLTs must now be prepared to assess and treat clients in the Irish language. This paper describes how an assessment of early expressive vocabulary and grammatical development for children aged between 16 and 40 months was adapted to Irish from the MacArthur-Bates Communicative Development Inventories (Fenson, Dale, Reznick , Bates , Thal, Pethnick, Tomasello, Mervis and Stiles, 1994). Ongoing work in piloting and measuring the validity and reliability of the parent-report instrument is also outlined. This study has implications for developing assessment tools for working with Irish-speaking and bilingual children.
Developing, monitoring, and reporting of fidelity in aphasia trials: core recommendations from the collaboration of aphasia trialists (CATs) trials for aphasia panel
(Taylor & Francis, 2022-03-13) Behn, Nicholas; Harrison, Madeleine; Brady, Marian C.; Breitenstein, Caterina; Carragher, Marcella; Fridriksson, Julius; Godecke, Erin; Hillis, Argye; Kelly, Helen; Palmer, Rebecca; Rose, Miranda L.; Thomas, Shirley; Tippett, Donna; Worrall, Linda; Becker, Frank; Hilari, Katerina; National Health and Medical Research Council; Bundesministerium für Bildung und Forschung; German Society for Aphasia Research and Treatment; National Institute on Deafness and Other Communication Disorders; Stroke Association; Tavistock Trust for Aphasia; Edith Cowan University
Background: Developing, monitoring, and reporting of fidelity are essential and integral components to the design of randomised controlled trials (RCTs) in stroke and aphasia. Treatment fidelity refers to the degree to which an intervention is delivered as intended and is directly related to the quality of the evidence generated by RCTs. Clear documentation of treatment fidelity in trials assists in the evaluation of the clinical implications of potential benefits attributed to the intervention. Consideration of the implementation requirements of a research-based intervention as intended in a clinical context is necessary to achieve similar outcomes for a clinical population. Despite this, treatment fidelity is rarely reported in RCTs of aphasia intervention. Aim: To describe fidelity strategies and develop core recommendations for developing, monitoring, and reporting of fidelity in aphasia intervention RCTs. Scope: Relevant conceptual frameworks were considered. The Behaviour Change Consortium comprehensive framework of fidelity was adopted. It includes five areas: study design, training providers, delivery of treatment, treatment receipt, and treatment enactment. We explored fidelity in RCTs with a range of complex aphasia interventions (e.g., ASK, Big CACTUS, COMPARE, FCET2EC, POLAR, SUPERB, and VERSE) and described how different trial design factors (e.g., phase of trial, explanatory vs. pragmatic, number and location of sites, and number and type of treatment providers) influenced the fidelity strategies chosen. Strategies were mapped onto the five areas of the fidelity framework with a detailed exploration of how fidelity criteria were developed, measured, and monitored throughout each trial. This information was synthesised into a set of core recommendations to guide aphasia researchers towards the adequate measurement, capture, and reporting of fidelity within future aphasia intervention studies. Conclusions/Recommendations: Treatment fidelity should be a core consideration in planning an intervention trial, a concept that goes beyond treatment adherence alone. A range of strategies should be selected depending on the phase and design of the trial being undertaken and appropriate investment of time and costs should be considered.
The development of a core key word signing vocabulary (Lámh) to facilitate communication with children with down syndrome in the first year of mainstream primary school in Ireland
(Taylor & Francis, 2022-04-13) Frizelle, Pauline; Lyons, Caoimhe; Irish Research Council
Key word signing, an unaided augmentative, and alternative communication (AAC) system is commonly used by children with Down syndrome who attend mainstream primary schools. To ensure the successful use of key word signing within a mainstream environment, a meaningful, contextually appropriate sign vocabulary must be available to all communication partners. The aim of this study was to develop a core school-based key word signing vocabulary to facilitate effective communication between children with Down syndrome and their communication partners in the first year of mainstream primary school. Four key groups-participants with Down syndrome, their peers, teachers, and special needs assistants-and a speech-language pathologist contributed to the vocabulary over the course of an academic year, through observations, semi-structured interviews, and guided tours of the school environment. Based on criteria of frequency and commonality, 140 words were considered to be core vocabulary. The current study provides new insights into the complex process of vocabulary selection for children who use key word signing at school and highlights the importance of access to a functional sign vocabulary in facilitating inclusive education practices.
The development of a core school-based Lámh vocabulary to facilitate effective communication between children with Down syndrome and their communication partners in the first year of mainstream primary school
(University College Cork, 2021-01-08) Lyons, Caoimhe; Frizelle, Pauline; Irish Research Council
Background: In Ireland, the entry-level key word sign (KWS) training for teachers and school staff is the Lámh Module 1 training course, which does not contain vocabulary specifically chosen to support school-age Lámh users. However, if KWS is to be used successfully by children with Down syndrome (DS) in a mainstream school environment, it is essential that communication partners have access to a meaningful, contextually appropriate sign vocabulary. Aim: To identify the Lámh vocabulary needs of children with DS and their communication partners over the course of the first year of mainstream primary school, with the aim of developing a core school-based Lámh vocabulary. Method: Five key groups contributed signs to the core vocabulary: participants with DS in junior infants (n=6), their teachers (n=5), special needs assistants (n=8), and peers (n=9), and the researcher (a Speech and Language Therapist). The researcher contributed signs based on observations of the classroom, the participants with DS contributed signs during guided tours of the school environment, and the teachers, SNAs and peers contributed signs by means of structured interviews. This data collection took place at four time points over the school year. Signs were considered to be part of the core vocabulary if they were contributed five times or more over the course of the year, and by three or more of the groups. Results: The core school-based Lámh vocabulary contained 140 words, including 132 Lámh signs and eight words that do not currently have a Lámh sign. Only 55 (39%) of the 140 signs recommended as core vocabulary for schools are part of the training currently most commonly accessed by school staff. The remaining 77 signs (55%) are part of more advanced training. Conclusion: The current study provides new insights into the complex process of vocabulary selection for children who use Lámh in a mainstream school environment. In addition, it highlights the importance of access to a functional sign vocabulary in facilitating an inclusive approach to education, and enhanced communicative practice by all of those engaging with children with DS in mainstream primary school.

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