Preventable adverse events (AEs) lead to poorer patient outcomes, added patient suffering and dissatisfaction, longer hospital stays, and billions in additional annual healthcare spending. Patients facing barriers to communication are three times more likely to experience a preventable adverse event than patients who faced no communication barriers. National data on hospital admissions, incidence and cost of preventable AEs, and the odds ratio regarding the risk of preventable AEs in people facing communication barriers were used to estimate potential benefits of improving patient communication. Reducing communication barriers could lead to an estimated reduction of 671,440 preventable AE cases and a cost savings of $6.8 billion annually. Facilitating patient-provider communication is an ethical and financial imperative. A multi-pronged approach, including increased awareness of and support for speech-language pathology services, is essential to creating a communication-friendly hospital culture, reducing patient suffering, and decreasing the financial cost of preventable AEs. Speech-language pathologists and allied healthcare professionals play a critical role in facilitating patient-provider communication and improving patient outcomes.
Purpose Understanding variability sources in early language interaction is critical to identifying children whose development is at risk and designing interventions. Variability across socioeconomic status (SES) groups has been extensively explored. However, SES is a limited individual clinical indicator. For example, it is not generally directly modifiable. The purpose of this study was to examine if child language ability, input quantity and quality, and dyadic interaction were associated with modifiable caregiver characteristics—self-efficacy and developmental knowledge. Method We conducted secondary analyses using the baseline data ( n = 41 dyads enrolled, n = 30 analyzed) from a longitudinal study. Mothers and children (1;0–2;3 [years;months]) in low-income households completed demographic questionnaires, self-efficacy and developmental knowledge measures, child language assessments, and interaction samples. We used linear regression models to examine the relationship between self-efficacy, developmental knowledge, and outcomes. Results Child receptive and expressive language scores were significantly associated with mothers' self-efficacy, knowledge, and Efficacy × Knowledge interaction. Specifically, maternal self-efficacy was positively associated with child language only in the context of high developmental knowledge. Neither self-efficacy nor developmental knowledge was significantly associated with the number of total or different words mothers produced. However, self-efficacy was significantly and positively associated with the rate of child-initiated conversational turns per minute, controlling for the number of child utterances. Mothers with higher self-efficacy responded more readily to their children than those with lower self-efficacy. Conclusions Child language ability and interaction quality vary based on modifiable parent characteristics. Modifiable individual characteristics should be considered in early language interaction within and across SES groups.
Purpose: Quantity and quality of early at-home reading shape literacy outcomes. At-home reading frequency is a common outcome measure in interventions. This single measure may not fully capture the quality of early reading interactions, such as parent and child references to print, an important contributor to language and literacy outcomes. This study aims to evaluate if and how reported reading frequency and duration are associated with parent and child print referencing, controlling for perceived parenting self-efficacy, developmental knowledge, and child sex. Method: This study is a secondary analysis of baseline data from a treatment study with parents ( N = 30) and children (1;1–2;3 [years;months]) from underresourced households. Parents reported weekly reading episode frequency and duration (in minutes). We coded parent–child book-sharing interactions to quantify use of print references. Results: Negative binomial regression modeling suggested that parents who reported more weekly reading episodes tended to use more print references during interactions. However, reported reading time in minutes was not significantly associated with parents' print referencing. Parents' print references were also associated with perceived self-efficacy, developmental knowledge, and child sex. In our sample, parents used more print references with male children. Neither reading frequency nor reading time was associated with increased print referencing from children. Conclusions: Duration of reading did not positively predict children's use of print references. However, weekly reading frequency positively predicted parents' use of print references. Parent perceived self-efficacy and knowledge may predict early interaction quality similarly to quantity of reading. Supplemental Material: https://doi.org/10.23641/asha.20669094
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