Telehealth services may be as effective as face-to-face interventions, which is encouraging given the potential benefits of telehealth in rural and remote areas with regards to healthcare access and time and cost savings.
Aim To determine the prevalence of drooling, swallowing, and feeding problems in persons with cerebral palsy (CP) across the lifespan. Method A systematic review was conducted using five different databases (AMED, CINAHL, Embase, MEDLINE, and PubMed). The selection process was completed by two independent researchers and the methodological quality of included studies was assessed using the STROBE and AXIS guidelines. Meta‐analyses were conducted to determine pooled prevalence estimates of drooling, swallowing, and feeding problems with stratified group analyses by type of assessment and Gross Motor Function Classification System level. Results A total of 42 studies were included. Substantial variations in selected outcome measures and variables were observed, and data on adults were limited. Pooled prevalence estimates determined by meta‐analyses were as high as 44.0% (95% confidence interval [CI] 35.6–52.7) for drooling, 50.4% (95% CI 36.0–64.8) for swallowing problems, and 53.5% (95% CI 40.7–65.9) for feeding problems. Group analyses for type of assessments were non‐significant; however, more severely impaired functioning in CP was associated with concomitant problems of increased drooling, swallowing, and feeding. Interpretation Drooling, swallowing, and feeding problems are very common in people with CP. Consequently, they experience increased risks of malnutrition and dehydration, aspiration pneumonia, and poor quality of life. What this paper adds Drooling, swallowing, and feeding problems are very common in persons with cerebral palsy (CP). The prevalence of drooling, swallowing, and feeding problems is 44.0%, 50.4%, and 53.5% respectively. There are limited data on the prevalence of drooling, swallowing, and feeding problems in adults. Higher Gross Motor Function Classification System levels are associated with higher prevalence of drooling, swallowing, and feeding problems. There is increased risk for malnutrition, dehydration, aspiration pneumonia, and poor quality of life in CP.
Given the barriers that inconsistent terminology poses for the Speech-Language Pathology (SLP) profession, this study aimed to develop an agreed upon taxonomy with well-defined categories for describing language assessment practices for children. Method:A taxonomy with illustrative terms for describing assessments across four aspects (modality/domain, purpose, delivery, and form) was developed with reference to contemporary literature. In a three round Delphi study, SLPs with expertise in child language were asked to indicate their level of agreement with the taxonomy and provide feedback.Participants were also asked to apply the taxonomy by categorising assessments presented in case studies. Results:A total of 55 participants completed round one, while 43 and 32 completed rounds two and three respectively. Agreed consensus with the taxonomy was achieved in both rounds one and two, with at least 88% of participants agreeing with each aspect and 100% agreeing with the overall structure. In round three, agreement was reached on 7/10 components for one case study and 4/10 for the other. Conclusion:The development of this taxonomy represents a significant step towards providing detailed terminology for describing language assessments. Future research is needed to investigate implementation strategies to facilitate consistent application of the taxonomy by SLPs.
As early diagnosis of swallowing and feeding difficulties in infants and children is of utmost importance, there is a need to evaluate the quality of the psychometric properties of pediatric assessments of swallowing and feeding. A systematic review was performed summarizing the psychometric properties of non-instrumental assessments for swallowing and feeding difficulties in pediatrics; no data were identified for the remaining twelve assessments. The COSMIN taxonomy and checklist were used to evaluate the methodological quality of 23 publications on psychometric properties. For each assessment, an overall quality score for each measurement property was determined. As psychometric data proved incomplete, conflicting or indeterminate for all assessments, only preliminary conclusions could be drawn; the most robust assessment based on current data is the dysphagia disorder survey (DDS). However, further research is needed to provide additional information on all psychometric properties for all assessments.
Purpose This study reports on data from a survey of speech-language pathologists' (SLPs) language assessment practices for elementary school–age children. The objective was to investigate the regularity with which SLPs use different types of assessments (described across data types, task types, environmental contexts, and dynamic features). This study also investigated factors that influence assessment practice, the main sources from which SLPs obtain information on language assessment and the main challenges reported by SLPs in relation to language assessment. Method A web-based survey was used to collect information from 407 Australian SLPs regarding the types of assessments they use. Factors that influenced the regularity with which different types of assessments were used were investigated using regression analysis. Results Most SLPs regularly used assessments that are norm-referenced, decontextualized, and conducted in a clinical context and less regularly used other types of assessments. Service agency, Australian state, and SLPs' years of experience were found to influence the regularity with which some types of assessments were used. Informal discussions with colleagues were the most frequently identified source of information on assessment practice. Main challenges related to limited time, lack of assessment materials, and lack of confidence in assessing children from culturally and linguistically diverse backgrounds. Conclusions SLPs could improve current language assessment practice for elementary school–age children through more regular use of some types of assessments. Actions to facilitate evidence-based assessment practice should consider the contextual differences that exist between service agencies and states and address challenges that SLPs experience in relation to language assessment. Supplemental Material https://doi.org/10.23641/asha.14378948
Progressive supranuclear palsy (PSP) is a progressive neurological condition, whose main features include supranuclear gaze palsy, frequent falls, bradykinesia, axial rigidity, cognitive decline and communication impairments. Even though communication impairments are early and prominent manifestations, there is a significant lack of research on the nature of these impairments in PSP and the role of speech-language pathologists (SLPs). This tutorial article aims to describe the communication impairments observed in people with PSP; provide clinical guidelines for SLPs when assessing motor speech, language and other communication impairments; and to present facilitation and compensation approaches to treatment for people with PSP. The predominant motor speech impairment is mixed dysarthria, but there is a lack of consensus about the classification of language impairments. The involvement of SLPs in the assessment and treatment of people with PSP should be early, on-going and in collaboration with other health professionals, with the primary focus of maintaining quality of life for these patients and their family members.
Purpose The current review was conducted to identify all self-report questionnaires on functional health status (FHS) and/ or health-related quality-of-life (HR-QoL) in adult populations with dysphonia (voice problems), and to evaluate the psychometric properties of the retrieved questionnaires. Methods A systematic review was performed in the electronic literature databases PubMed and Embase. The psychometric properties of the questionnaires were determined using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) taxonomy and checklist. Responsiveness was outside the scope of this review and as no agreed 'gold standard' measures are available in the field of FHS and HR-QoL in dysphonia, criterion validity was not assessed. Only questionnaires developed and published in English were included. Results Forty-eight studies reported on the psychometric properties of 15 identified questionnaires. As many psychometric data were missing or resulted from biased study designs or statistical analyses, only preliminary conclusions can be drawn. Based on the current available psychometric evidence in the literature, the Voice Handicap Index seems to be the most promising questionnaire, followed by the Vocal Performance Questionnaire. Conclusions More research is needed to complete missing data on psychometric properties of existing questionnaires in FHS and/or HR-QoL. Further, when developing new questionnaires, the use of item response theory is preferred above classical testing theory, as well as international consensus-based psychometric definitions and criteria to avoid bias in outcome data on measurement properties.
Implementation of a universal speech screen utilising parent-rated measures of children's speech cannot be introduced without further research.
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