Speech and Hearing Sciences - Journal Articles
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Item How reliable is assessment of children’s sentence comprehension using a self-directed app? A comparison of supported versus independent use(Cambridge University Press, 2023-08-14) Frizelle, Pauline; Buckley, Ana; Biancone, Tricia; Ceroni, Anna; Dahly, Darren L.; Fletcher, Paul; Bishop, Dorothy V. M.; McKean, Cristina; Health Research BoardThis study reports on the feasibility of using the Test of Complex Syntax- Electronic (TECS-E), as a self-directed app, to measure sentence comprehension in children aged 4 to 5 ½ years old; how testing apps might be adapted for effective independent use; and agreement levels between face-to-face supported computerized and independent computerized testing with this cohort. A pilot phase was completed with 4 to 4;06-year-old children, to determine the appropriate functional app features required to facilitate independent test completion. Following the integration of identified features, children completed the app independently or with adult support (4–4;05 (n = 22) 4;06–4;11 months (n = 55) and 5 to 5;05 (n = 113)) and test re-test reliability was examined. Independent test completion posed problems for children under 5 years but for those over 5, TECS-E is a reliable method to assess children’s understanding of complex sentences, when used independentlyItem The feasibility of measuring fidelity of implementation in parent-child interaction therapy: A clinician and parent fidelity study(Taylor & Francis, 2023-02-01) O'Toole, Ciara; Cronin, Sarah; Kearney, Mide; Flynn, Deirdre; Frizelle, Pauline; Down Syndrome IrelandPurpose: Measuring fidelity of implementation in parent-child interaction therapy (PCIT) involves assessing the training delivered by clinicians and how parents implement the techniques with their children. The aim of this study was to determine the feasibility of measuring fidelity of implementation for a PCIT intervention designed for young children with Down syndrome. Method: We applied a framework to measure dosage, adherence, quality, and participant responsiveness using a mixed methods approach with observational and interview data. Result: Our results showed that clinicians delivered 94% of the planned dosage; they adhered to the goals of program and reached the quality criterion in 4/6 rated sessions. Parents described their ability to engage with the program and perceived that it changed how they interacted and communicated with their children. Parents were unable to collect dosage data, but did adhere to 7/9 of the targeted techniques and met the quality criterion on 6/9 of these. It was also possible to measure the children’s responsiveness scores when interacting with parents during the intervention. Conclusion: This study revealed the opportunities and challenges that occur when measuring fidelity of implementation. There is a need to refine definitions of fidelity measures and to develop appropriate measurement tools so that a more consistent and useful framework can be used by speech-language pathologists (SLPs) to measure fidelity.Item 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 UniversityBackground: 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.Item Speech and language therapy services for people with Down syndrome: The disparity between research and practice(John Wiley & Sons, Inc., 2021-12-16) Frizelle, Pauline; Ceroni, Anna; Bateman, Lorna; Hart, NicolaThe need for speech and language therapy (SLT) for people with Down syndrome (DS) is well documented. However, there is a significant disparity between research and practice. This study addresses two of the three pillars of evidence-based practice by 1) quantitatively profiling some key features of the 2019 public SLT service in Ireland, and referencing this against current best evidence; 2) asking parents, and adults with DS what supports they need in relation to an adequate SLT service. Adults with DS (n = 33) and parents of those with DS (n = 557), completed an anonymous survey online. The function of the survey was to collect information on: SLT service provision; levels of satisfaction with services; and SLT supports required. Based on parent responses, only 44% of participants (n = 253) were offered public SLT services in 2019. The mode waiting time was 1–2 years and the average number of sessions across the age groups was 5 per year. There was a strong association between age and number of sessions. Individual therapy was the most common model of service. A total of 40% of parents reported a 0 level of satisfaction. Seven key themes emerged from the qualitative support data. None of the participating adults received public SLT services in 2019. Our aspiration for evidence-based SLT practice is far from being realized. The average number of sessions reported, does not in any way approximate the intervention intensity specified in evidence-based interventions. Our limited service, at all ages, has detrimental implications for people with DS and our negligible adult service is in breach of human rights. Targeted, strategic investment is needed to allow practice to be aligned with best evidence; to support and treat people with DS effectively; to allow them to reach their maximum potential; and to exercise their right to communicate.Item 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, ElizabethThis 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.