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: 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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Children with developmental language disorders (DLDs) may experience barriers to communicative participation. Communicative participation is defined as ‘participation in life situations in which knowledge, information, ideas or feelings are exchanged’. Barriers experienced in communicative participation cannot be explained by language competence alone and are thought to be influenced by contextual factors. A better understanding of these factors will contribute to tailored speech and language therapy services for children with DLD. We conducted a focus group study with 13 speech and language therapists’ (SLTs) to explore their perspectives on contextual (environmental and personal) factors in early childhood that are associated with communicative participation in children with DLD. The personal factor of child well-being, and the environmental factors of familial support and SLT service provision were developed through thematic analysis. The potential mediating role of these factors on communicative participation implies that it is important to address contextual barriers and facilitators in speech and language therapy services.
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Lopend onderzoek in het kader van de onderzoekslijn Kind, Taal & Ontwikkeling. Deze onderzoekslijn maakt deel uit van het Lectoraat Transparante Zorgverleningen en het Lectoraat Integraal Jeugdbeleid. Language problems have impact on school succes (Beichtman et al., 1996, Nelson et al., 2006), behavior (Coster et al., 1999), and quality of life (Van Agt, 2011). Also the comorbidity with other developmental disorders like dyslexia, ADHD and ASS is high (Gerrits, 2011). Psychological wellbeing depends on the interaction with others (Steenbeek & Geert, 2007), in which speech and language are important tools. Identification of children at risk for speech and language delays and related problems may lead to appropriate follow-up and interventions at a young age, when chances for improvement are best (Nelson, 2006). Therefore, it is of great importance to monitor the speech and language development and its consequences during early childhood. In the Netherlands, several protocols exist to detect children with speech and language delay and to guide them to appropriate care. Though, the balance between health benefits, costs, scope and adverse results of these protocols are not evaluated. In 2009, the RIVM and the NCJ formulated a practice based guideline for the screening of children with speech and language delays in Child Health Care (CHC). This position statement is based on consensus in the field. The goal of this study is to collect evidence for the scientific underpinnings of the current practice-based guidelines of the NCJ. We want to evaluate the improvements of speech and language outcomes as well as non speech and language outcomes a year after CHC-screening 2-year-old children.
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Purpose Although researchers have explored parental perspectives on childhood speech and language disorders, this work has mostly been conducted in English-speaking countries. Little is known about parental experiences across countries. Participation in the COST Action IS1406 ‘Enhancing children’s oral language skills across Europe and beyond’ provided an opportunity to conduct cross-cultural qualitative interviews. The aims were to explore how parents construe inclusion and/or exclusion of their child and how parents involve themselves in order to facilitate inclusion. Method Parents from nine countries and with a child who had received services for speech-language disorder participated in semi-structured qualitative interviews. We used thematic analysis to analyze the data. Results Two overarching themes were identified: ‘Language disabilities led to social exclusion’ and ‘Promoting pathways to social inclusion’. Two subthemes were identified Interpersonal relationships are important and Deliberate proactiveness as stepping stones for social inclusion. Conclusions Across countries, parents report that their children’s hidden disability causes misunderstandings that can lead to social exclusion and that they are important advocates for their children. It is important that the voices and experiences of parents of children with developmental disabilities are understood and acknowledged. Parents’ recommendations about how to support social inclusion need to be addressed at all levels of society.
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OBJECTIVE: The purpose of this study was to provide a description of the language and speech (intelligibility, voice, resonance, articulation) in a 7-year-old Dutch speaking boy with Nager syndrome. To reveal these features comparison was made with an age and gender related child with a similar palatal or hearing problem. METHODS: Language was tested with an age appropriate language test namely the Dutch version of the Clinical Evaluation of Language Fundamentals. Regarding articulation a phonetic inventory, phonetic analysis and phonological process analysis was performed. A nominal scale with four categories was used to judge the overall speech intelligibility. A voice and resonance assessment included a videolaryngostroboscopy, a perceptual evaluation, acoustic analysis and nasometry. RESULTS: The most striking communication problems in this child were expressive and receptive language delay, moderately impaired speech intelligibility, the presence of phonetic and phonological disorders, resonance disorders and a high-pitched voice. The explanation for this pattern of communication is not completely straightforward. The language and the phonological impairment, only present in the child with the Nager syndrome, are not part of a more general developmental delay. The resonance disorders can be related to the cleft palate, but were not present in the child with the isolated cleft palate. One might assume that the cul-de-sac resonance and the much decreased mandibular movement and the restricted tongue lifting are caused by the restricted jaw mobility and micrognathia. To what extent the suggested mandibular distraction osteogenesis in early childhood allows increased mandibular movement and better speech outcome with increased oral resonance is subject for further research. CONCLUSION: According to the results of this study the speech and language management must be focused on receptive and expressive language skills and linguistic conceptualization, correct phonetic placement and the modification of hypernasality and nasal emission.
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Purpose: This case study is presented to inform the reader of potential speech, language, cognitive, and emotional characteristics in preadolescent cluttering. Method: This case study describes a 10-year-old boy who started to clutter during preadolescence. The case illustrates that, in some adolescents, cluttering can co-occur with temporary stuttering-like behavior. In this case, signs of disturbances in speech-language production associated with behavioral impulsiveness as a young child were noted. Speech, language, cognitive, and emotional results of the case are reported in detail. Results: The changes in fluency development are reported and discussed within the context of changes in the adolescent brain as well as adolescent cognitive and emotional development. While being unaware of their speech condition before adolescence, during preadolescence, the changes in brain organization lead to an increase in rate and a decrease in speech control. Given that the client had limited understanding of what was occurring, they were at risk of developing negative communication attitudes. Speech-language therapists are strongly advised to monitor children with cluttering signals in the early years of their adolescence.
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From the article: "Individuals with dementia often experience a decline in their ability to use language. Language problems have been reported in individuals with dementia caused by Alzheimer’s disease, Parkinson’s disease or degeneration of the fronto-temporal area. Acoustic properties are relatively easy to measure with software, which promises a cost-effective way to analyze larger discourses. We study the usefulness of acoustic features to distinguish the speech of German-speaking controls and patients with dementia caused by (a) Alzheimer’s disease, (b) Parkinson’s disease or (c) PPA/FTD. Previous studies have shown that each of these types affects speech parameters such as prosody, voice quality and fluency (Schulz 2002; Ma, Whitehill, and Cheung 2010; Rusz et al. 2016; Kato et al. 2013; Peintner et al. 2008). Prior work on the characteristics of the speech of individuals with dementia is usually based on samples from clinical tests, such as the Western Aphasia Battery or the Wechsler Logical Memory task. Spontaneous day-to-day speech may be different, because participants may show less of their vocal abilities in casual speech than in specifically designed test scenarios. It is unclear to what extent the previously reported speech characteristics are still detectable in casual conversations by software. The research question in this study is: how useful for classification are acoustic properties measured in spontaneous speech."
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Cleft lip and/or palate (CL/P) is a congenital craniofacial defect that arises on average in 1.7 per 1000 live births. This anomaly causes atypical facial appearance, hearing problems, malocclusions and speech disorders. Outcomes in terms of speech are influenced by timing of surgical cleft closure. In the Comprehensive Rehabilitation Services in Uganda (CoRSU) hospital, closure of the entire cleft during a single surgery prior to the age of 6 months is preferred in view of reducing default rates for second surgery and decreasing risks for malnutrition and death. However, some patients arrive the first time at the hospital in later childhood, youth or adulthood. No information about satisfaction and speech outcome was yet available for these Ugandan patients. Moreover, only few, if any studies systematically assessed satisfaction and speech following similar surgical timing protocols. Therefore, in view of searching for the optimal surgical treatment for patients with CL/P, the general aim of the current doctoral thesis was to verify satisfaction and speech in Ugandan patients with CL/P repaired in CoRSU by one experienced surgeon using the Sommerlad technique for palatal closure. In view of clinics and further research, normative nasalance values were first obtained in Ugandan English-speaking males and females (age: 2;7 to 13;5 years) without craniofacial anomalies. No significant age and gender differences were observed. Second, parental satisfaction was studied in Ugandan children with unilateral or bilateral cleft lip and palate (CLP) following synchronous lip and palatal closure. Overall high levels of satisfaction were noted for appearance of lip, nose and face, despite lower satisfaction levels for teeth appearance and speech. Comparison with an age- and gender-matched non-cleft control group revealed significant higher parental dissatisfaction for speech and appearance of teeth and nose in Ugandan patients with CLP. Third, articulation and resonance characteristics of Ugandan patients with early synchronous closure of C(L)P (≤ 6 months) were assessed. Comparison with an age- and gender-matched non-cleft control group revealed various deviations from normal speech development. The Ugandan CP group showed significantly smaller consonant inventories as well as significantly more phonetic disorders, phonological processes and nasal emission/turbulence compared to the control group. In addition, Ugandan patients with C(L)P were compared to a Belgian CP group (matched for cleft type, age and gender) who underwent palatal repair after the age of 6 months. A Ugandan and Belgian age- and gender-matched non-cleft control group was included to control for language, culture and other environmental factors. Comparison of the Ugandan and Belgian CP group revealed at least similar articulation and resonance characteristics. No significant group differences were obtained for perceptual evaluation of resonance, mean nasalance values of oral speech samples, consonant inventories and most phonetic errors and phonological processes. However, the Belgian CP group showed significantly more distortions due to higher occurrence frequencies for (inter)dental articulation of apico-alveolar consonants. Finally, articulation and resonance characteristics as well as patients’ satisfaction with speech were verified in Ugandan patients following delayed one-stage soft and hard palatal closure (≥ 8 years). Comparison with an age- and gender-matched non-cleft control group revealed overall low satisfaction with speech and severely disordered articulation and resonance. The patient group showed significantly smaller consonant inventories, more phonetic and phonological disorders, more hypernasality and nasal emission/turbulence as well as higher mean nasalance values for oral and oronasal speech samples compared to the control group. When findings of the current doctoral thesis are placed within a broader framework, early closure of the entire cleft during a single surgery seems to be an appropriate surgical timing protocol for resource-poor countries. However, prior to application in northern countries, more information on maxillofacial growth disturbances is required. Furthermore, when youngsters and adults present with untreated clefts, delayed cleft repair might be of value, although speech outcomes are poor.
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Dit artikel beschrijft de bevindingen uit een explorerend literatuuronderzoek naar de grammaticale ontwikkeling van Nederlandstalige kinderen tussen 7 en 10 jaar met en zonder een taalontwikkelingsstoornis (TOS). De resultaten worden ook in een klinische context geplaatst, met als doel logopedisten te ondersteunen in de behandeling van grammaticale problemen bij kinderen met TOS in deze leeftijdsgroep. Grammaticale problemen zijn een kernprobleem van kinderen metTOSen behandeling van deze grammaticale problemen is daarmee een kerntaak van de logopedist. De verwervingsvolgorde van grammaticale structuren bij Nederlandstalige kinderen met een normale taalontwikkeling is redelijk duidelijk tot een leeftijd van 5 á 6 jaar. Voor oudere kinderen is dit veel minder het geval. Deze informatie is echter wel van belang om passende grammaticale behandeldoelen te kunnen selecteren en prioriteren.
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