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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communicative participation, language disordersOBJECTIVE(S)/RESEARCH QUESTION(S) Speech and language therapists (SLTs) are the primary care professionals to treat language and communication disorders. Their treatment is informed by a variety of outcome measures. At present, diagnosis, monitoring of progress and evaluation are often based on performance-based and clinician-reported outcomes such as results of standardized speech, language, voice, or communication tests. These tests typically aim to capture how well the person can produce or understand language in a controlled situation, and therefore only provide limited insight in the person’s challenges in life. Performance measures do not incorporate the unobservable feelings such as a patient's effort, social embarrassment, difficulty, or confidence in communication. Nor do they address language and communication difficulties experienced by the person themselves, the impact on daily life or allow patients to set goals related to their own needs and wishes. The aim of our study is give our patients a voice and empower SLTs to incorporate their patient's perspective in planning therapy. We will Aangemaakt door ProjectNet / Generated by ProjectNet: 08-12-2020 12:072Subsidieaanvraag_digitaal / Grant Application_digitaalDossier nummer / Dossier number: 80-86900-98-041DEFINITIEFdevelop a valid and reliable patient-reported outcome measure that provides information on communicative participation of people with communication disorders and integrate this item bank in patient specific goal setting in speech and language therapy. Both the item bank and the goal setting method will be adapted in cocreation with patients to enable access for people with communication difficulties.STUDY DESIGN Mixed methods research design following the MRC guidance for process evaluation of complex interventions, using PROMIS methodology including psychometric evaluation and an iterative user-centered design with qualitative co-creation methods to develop accessible items and the goal setting method.RESEARCH POPULATION Children, adolescents and adults with speech, language, hearing, and voice disorders.OUTCOME MEASURES An online patient-reported outcome measure on communicative participation, the Communicative Participation Item Bank (CPIB), CPIB items that are accessible for people with language understanding difficulties, a communicative-participation person-specific goal setting method developed with speech and language therapists and patients and tested on usability and feasibility in clinical practice, and a course for SLTs explaining the use of the goal-setting method in their clinical reasoning process.RELEVANCE This study answers one of the prioritized questions in the call for SLTs to systematically and reliably incorporate the clients’ perspective in their daily practice to improve the quality of SLT services. At present patient reported outcomes play only a small role in speech and language therapy because 1) measures (PROMS) are often invalid, not implemented and unsuitable for clinical practice and 2) there is a knowledge gap in how to capture and interpret outcomes from persons with language disorders.
