Inter)nationally there is discussion about whether auditory processing disorders (APD) should be seen as a unique clinical diagnosis and what is the most appropriate diagnosis and referral of children in this target group. In this context, the Dutch Audiological Centres (AC) have different care pathways for children with so-called unexplained listening difficulties. The purpose of the current document is to provide professionals with tools to identify, diagnose and treat children with listening difficulties. The Dutch Position Statement Children with Listening Difficulties has been developed based on current scientific evidence of listening difficulties, and based on meetings held with professionals. Professionals in the Dutch Audiological Centres have reached a consensus with the following 9 statements: Definition: (1) The target group 'Children with listening difficulties' is not a unique and demonstrable clinical entity. (2) The problems of children with listening difficulties are multimodal. (3) The symptoms of children with listening difficulties may also occur in children with other developmental disorders such as AD(H)D, DLD, dyslexia and learning disorders. Detection and referral: (4) After detection of listening difficulties, children can be referred to a multidisciplinary centre. Diagnostics: (5) When diagnosing a child with listening difficulties, an audiologist, a speech language therapist and a behavioral scientist must be involved. (6) Listening difficulties are initially mapped using patient history (with client-centred focus) and, if available, a validated questionnaire. (7) In the case of children with listening difficulties, a speech-in-noise test is always carried out in addition to the pure tone and speech audiometry (8) The diagnostic procedure for listening difficulties starts from a broad perspective on development. Therapy: (9) For children with listening difficulties, intervention is focused on the client’s needs and focuses on action-oriented practice. This document informs professionals in the Netherlands, who are working with children who are referred because of listening difficulties in the absence of hearing loss, about the current evidence available and about the consensus in the Netherlands.
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Background: Collaboration between Speech and Language Therapists (SLTs) and parents is considered best practice for children with developmental disorders. However, such collaborative approach is not yet implemented in therapy for children with developmental language disorders (DLD) in the Netherlands. Improving Dutch SLTs’ collaboration with parents requires insight in factors that influence the way SLTs work with parents. Aims: To explore the specific beliefs of Dutch SLTs that influence how they collaborate with parents of children with DLD. Methods and procedures: We conducted three online focus groups with 17 SLTs using a reflection tool and fictional examples of parents to prompt their thoughts, feelings and actions on specific scenarios. Data were organised using the Theoretical Domains Framework (TDF). Outcomes and results: We identified 34 specific beliefs across nine TDF domains on how SLTs collaborate with parents of children with DLD. The results indicate that SLTs hold beliefs on how to support SLTs in collaborating with parents but also conflicting specific beliefs regarding collaborative work with parents. The latter relate to SLTs’ perspectives on their professional role and identity, their approach towards parents, and their confidence and competence in working collaboratively with parents.
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AimTo investigate: (a) language difficulties in children with developmental coordination disorder (DCD), and (b) motor difficulties in children with developmental language disorder (DLD).MethodIn this systematic review, PubMed, CINAHL, PsycINFO, and Embase were searched to identify peer-reviewed studies. Two researchers independently identified, screened and evaluated the methodological quality of the included studies following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). For objective (a), we combined the terms: “developmental coordination disorder” AND “language skills” AND “children”. For objective (b) we combined the terms: “developmental language disorder” AND “motor skills” AND “children”.ResultsTen studies on language skills in children with DCD and 34 studies on motor skills in children with DLD are included, most with relatively good methodological quality. The results for language comprehension and production in children with DCD are contradictory, but there is evidence that children with DCD have communication and phonological problems. Evidence for general motor problems in children with DLD is consistent. Studies report problems in balance, locomotor, and fine motor skills in children with DLD. Evidence for aiming and catching skills is inconsistent.InterpretationThe findings of this systematic review highlight the co-occurrence of language impairments in children with DCD and motor impairments in children with DLD. Healthcare professionals involved in the assessment and diagnosis of children with DCD or DLD should be attentive to this co-occurrence. In doing so, children with DCD and DLD can receive optimal interventions to minimize problems in their daily life.
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Purpose: Most speech-language pathologists (SLPs) working with children with developmental language disorder (DLD) do not perform language sample analysis (LSA) on a regular basis, although they do regard LSA as highly informative for goal setting and evaluating grammatical therapy. The primary aim of this study was to identify facilitators, barriers, and needs related to performing LSA by Dutch SLPs working with children with DLD. The secondary aim was to investigate whether a training would change the actual performance of LSA. Method: A focus group with 11 SLPs working in Dutch speech-language pathology practices was conducted. Barriers, facilitators, and needs were identified using thematic analysis and categorized using the theoretical domain framework. To address the barriers, a training was developed using software program CLAN. Changes in barriers and use of LSA were evaluated with a survey sent to participants before, directly after, and 3 months posttraining. Results: The barriers reported in the focus group were SLPs’ lack of knowledge and skills, time investment, negative beliefs about their capabilities, differences in beliefs about their professional role, and no reimbursement from health insurance companies. Posttraining survey results revealed that LSA was not performed more often in daily practice. Using CLAN was not the solution according to participating SLPs. Time investment remained a huge barrier. Conclusions: A training in performing LSA did not resolve the time investment barrier experienced by SLPs. User-friendly software, developed in codesign with SLPs might provide a solution. For the short-term, shorter samples, preferably from narrative tasks, should be considered.
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In order to optimize collaboration between Speech and Language Therapists (SLTs) and parents of children with Developmental Language Disorders (DLD), our aim was to study what is needed for SLTs to transition from the parent-as-therapist aide model to the FCC model and optimal collaborate with parents. Chapter 2 discusses the significance of demystifying collaborative working by making explicit how collaboration works. Chapter 3 examines SLTs’ perspectives on engaging parents in parent-child interaction therapy, utilizing a secondary analysis of interview data. Chapter 4 presents a systematic review of specific strategies that therapists can employ to enhance their collaboration with parents of children with developmental disabilities. Chapter 5 explores the needs of parents in their collaborative interactions with SLTs during therapy for their children with DLD, based on semi-structured interviews. Chapter 6 reports the findings from a behavioral analysis of how SLTs currently engage with parents of children with DLD, using data from focus groups. Chapter 7 offers a general discussion on the findings of this thesis, synthesizing insights from previous chapters to propose recommendations for practice and future research.
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BACKGROUND: Atypical speech and language development is one of the most common developmental difficulties in young children. However, which clinical signs characterize atypical speech-language development at what age is not clear.AIM: To achieve a national and valid consensus on clinical signs and red flags (i.e. most urgent clinical signs) for atypical speech-language development in children from 1 to 6 years of age.METHODS & PROCEDURES: A two-round Delphi study in the Netherlands with a national expert panel (n = 24) of speech and language therapists was conducted. The panel members responded to web-based questionnaires addressing clinical signs. Consensus was defined as ≥ 70% of the experts agreeing on an issue.OUTCOMES & RESULTS: The first round resulted in a list of 161 characteristics of atypical speech and language development. The second round led to agreement on 124 clinical signs and 34 red flags.CONCLUSIONS & IMPLICATIONS: Dutch national consensus concerns 17-23 clinical signs per age year for the description of an atypical speech-language development in young children and three to 10 characteristics per age year being red flags for atypical speech-language development. This consensus contributes to early identification and diagnosis of children with atypical speech-language development, awareness and research.
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The importance of hearing parents of deaf and hard-of-hearing (DHH) children learning sign language is well documented. However, parents face many challenges in this learning process. This study investigates the experiences of Dutch hearing parents learning Dutch Sign Language (NGT) or Sign-supported Dutch through semi-structured interviews with 21 parents and 6 NGT teachers. The interviews explored parents’ and teachers’ perspectives on parental sign language courses, additional learning materials, and the challenges parents face in learning sign language. The findings highlight the value of DHH teachers and home-based initial courses, as well as the importance of courses aligning with the child’s developmental stage and extending beyond vocabulary level. Both parents and teachers appreciated learning materials that could be used together by parent and child but expressed a need for additional and more elaborate resources. Common challenges included language-specific difficulties, such as mastering sign order and adapting to a visual language, and external barriers, such as difficulties accessing courses and conf licting expert advice regarding the use of sign language. These findings underscore the need for more accessible courses, longer-duration support, and greater consistency among professionals in their advice. This would better support hearing parents in effectively learning sign language and ensuring their DHH children have full access to language from an early age.
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Worldwide, pupils with migrant backgrounds do not participate in school STEM subjects as successfully as their peers. Migrant pupils’ subject-specific language proficiency lags behind, which hinders participation and learning. Primary teachers experience difficulty in teaching STEM as well as promoting required language development. This study investigates how a professional development program (PDP) focusing on inclusive STEM teaching can promote teacher learning of language-promoting strategies (promoting interaction, scaffolding language and using multilingual resources). Participants were five case study teachers in multilingual schools in the Netherlands (N = 2), Sweden (N = 1) and Norway (N = 2), who taught in primary classrooms with migrant pupils. The PDP focused on three STEM units (sound, maintenance, plant growth) and language-promoting strategies. To trace teachers’ learning, three interviews were conducted with each of the five teachers (one after each unit). The teachers also filled in digital logs (one after each unit). The interviews showed positive changes in teachers’ awareness, beliefs and attitudes towards language-supporting strategies. However, changes in practice and intentions for practice were reported to a lesser extent. This study shows that a PDP can be an effective starting point for teacher learning regarding inclusive STEM teaching. It also illuminates possible enablers (e.g., fostering language awareness) or hinderers (e.g., teachers’ limited STEM knowledge) to be considered in future PDP design.
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Background: Early detection and remediation of language disorders are important in helping children to establish appropriate communicative and social behaviour and acquire additional information about the world through the use of language. In the Netherlands, children with (a suspicion of) language disorders are referred to speech and hearing centres for multidisciplinary assessment. Reliable data are needed on the nature of language disorders, as well as the age and source of referral, and the effects of cultural and socioeconomic profiles of the population served in order to plan speech and language therapy service provision. Aims: To provide a detailed description of caseload characteristics of children referred with a possible language disorder by generating more understanding of factors that might influence early identification. Methods & Procedures: A database of 11,450 children was analysed consisting of data on children, aged 2–7 years (70% boys, 30% girls), visiting Dutch speech and hearing centres. The factors analysed were age of referral, ratio of boys to girls, mono‐ and bilingualism, nature of the language delay, and language profile of the children. Outcomes & Results:Results revealed an age bias in the referral of children with language disorders. On average, boys were referred 5 months earlier than girls, and monolingual children were referred 3 months earlier than bilingual children. In addition, bilingual children seemed to have more complex problems at referral than monolingual children. They more often had both a disorder in both receptive and expressive language, and a language disorder with additional (developmental) problems. Conclusions & Implications: This study revealed a bias in age of referral of young children with language disorders. The results implicate the need for objective language screening instruments and the need to increase the awareness of staff in primary child healthcare of red flags in language development of girls and multilingual children aiming at earlier identification of language disorders in these children.
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