Comparing in-Person and Telepractice Service Delivery for Spoken Language Production and Comprehension Using the National Outcomes Measurement System.

The American Speech-Language-Hearing Association (ASHA) developed the National Outcomes Measurement System for aggregating standardized patient outcomes. Outcomes are standardized using Functional Communication Measures (FCM), scales designed to describe communicative function across specific areas of clinical need. This investigation compared in-person and telepractice service delivery for children in elementary school settings who received treatment targeting the FCM categories of either "spoken language production" or "spoken language comprehension." De-identified cases were secured from ASHA's NOMS database and the database of a private e-learning provider that implemented the NOMS format. There were minimal significant differences in the median change scores between the traditional and telepractice interventions. These results support comparable treatment outcomes between in-person service delivery and telepractice for treatment of children exhibiting impaired spoken language production or spoken language comprehension in an elementary school setting.

Utterance Duration as It Relates to Communicative Variables in Infant Vocal Development.

Purpose: We aimed to provide novel information on utterance duration as it relates to vocal type, facial affect, gaze direction, and age in the prelinguistic/early linguistic infant. Method: Infant utterances were analyzed from longitudinal recordings of 15 infants at 8, 10, 12, 14, and 16 months of age. Utterance durations were measured and coded for vocal type (i.e., squeal, growl, raspberry, vowel, cry, laugh), facial affect (i.e., positive, negative, neutral), and gaze direction (i.e., to person, to mirror, or not directed). Results: Of the 18,236 utterances analyzed, durations were typically shortest at 14 months of age and longest at 16 months of age. Statistically significant changes were observed in utterance durations across age for all variables of interest. Conclusion: Despite variation in duration of infant utterances, developmental patterns were observed. For these infants, utterance durations appear to become more consolidated later in development, after the 1st year of life. Indeed, 12 months is often noted as the typical age of onset for 1st words and might possibly be a point in time when utterance durations begin to show patterns across communicative variables.

Students' self-perceptions of interprofessional education following participation on a diagnostic team for autism spectrum disorder.

Interprofessional education is essential for producing future allied-health and education professionals. Unfortunately, opportunities for students to get authentic interprofessional field-based experiences are lacking. This pilot study explored students' self-perceptions towards interprofessional education (IPE) following participation on an interprofessional diagnostic team designed to rule in or out the diagnosis of autism spectrum disorder (ASD). Thirty-nine students from seven professions responded to a survey before and after completing this interprofessional education experience. The results indicated that the students' self-perceptions remained consistent during the experience. They reflected positive self-perceptions in the areas of collaboration, professional identity, and the desire to work with others, all in the context of an ASD-focused team. The findings suggest that students entering the IPE experience with positive expectations remained positive during the experience. This pilot study provides support for the benefits of providing students with the opportunity to engage in authentic collaborative practice when working with children with ASD.

A survey of knowledge and practices regarding prevention of unintended pregnancies.

PURPOSE: The purpose of this study was to identify the gaps in Kansas physician assistant practices and knowledge regarding prevention of unintended pregnancies with the aim of reducing the unintended pregnancy rate. METHODS: A survey targeting all licensed physician assistants in Kansas (N = 733) was developed based on a literature review of contraceptive behaviors, unintended pregnancy data, and providers' practices. RESULTS: The response rate was 22%. Most knowledge questions were answered incorrectly, with almost 60% of respondents underestimating the percent of both unintended pregnancies and abortions resulting from them. Eighty percent did not know that abstinence among teenagers is increasing. An average of only 28% of respondents frequently counseled teens to get contraception before their first intercourse, and counseling about highly effective reversible contraception beyond oral contraceptives was limited. Only 13% reported having been trained in intrauterine device (IUD) insertion. Of the physician assistant respondents who prescribe oral contraceptives, 42% reported ordering a 1-month supply for patients, despite risk of usage gaps. CONCLUSIONS: Areas where Kansas physician assistants could improve were identified. Increased counseling of teenagers about (a) highly effective methods of contraception and (b) contraception before their first intercourse is recommended. Training physician assistants in IUD insertion and prescribing oral contraceptives to dispense multiple months at once could result in fewer unintended pregnancies.

Hydration in older adults: the contribution of bioelectrical impedance analysis.

The sensory and gastrointestinal changes that occur with ageing affect older adults' food and liquid intake. Any decreased liquid intake increases the risk for dehydration. This increased dehydration risk is compounded in older adults with dysphagia. The availability of a non-invasive and easily administered way to document hydration levels in older adults is critical, particularly for adults in residential care. This pilot study investigated the contribution of bioelectrical impedance analysis to measure hydration in 19 older women in residential care: 13 who viewed themselves as healthy and six with dysphagia. Mann-Whitney U analyses documented no significant between-group differences for Total Body Water (TBW), Fat Free Mass (FFM), Fat Mass (FM), and percentage Body Fat (%BF). However, when compared to previously published data for age-matched women, the TBW and FFM values of the two participant groups were notably less, and FM and %BF values were notably greater than expected. If results are confirmed through continued investigation, such findings may suggest that long-term care facilities are unique environments in which all older residents can be considered at-risk for dehydration and support the use of BIA as a non-invasive tool to assess and monitor their hydration status.

Overcoming barriers to investigating mother-infant interactions in the first two hours of life.

As a result of the unexpected delays experienced in a study designed to investigate mother-infant interactions and infant cry patterns in the first 2 hours following delivery, the study was assessed to identify the barriers that the investigators had encountered in its planning and conduct. These barriers can be categorized as issues with (1) institutional review board approval, (2) participant recruitment and retention, (3) requirements for study personnel, (4) instrumentation, (5) potential observer and participant bias, and (6) budgeting. Each barrier is detailed, along with suggested solutions. It is hoped that that these experiences will be of value to other researchers, particularly those working in non-research-intensive institutions, as they gather data to contribute to the understanding of mother-infant interactions in the immediate postpartum period.

Syllable-related breathing in infants in the second year of life.

PURPOSE: This study explored whether breathing behaviors of infants within the 2nd year of life differ between tidal breathing and breathing supporting single unarticulated syllables and canonical/articulated syllables. METHOD: Vocalizations and breathing kinematics of 9 infants between 53 and 90 weeks of age were recorded. A strict selection protocol was used to identify analyzable breath cycles. Syllables were categorized on the basis of consensus coding. Inspiratory and expiratory durations, excursions, and slopes were calculated for the 3 breath cycle types and were normalized using mean tidal breath measures. RESULTS: Tidal breathing cycles were significantly different from syllable-related cycles on all breathing measures. There were no significant differences between unarticulated syllable cycles and canonical syllable cycles, even after controlling for utterance duration and sound pressure level. CONCLUSIONS: Infants in the 2nd year of life exhibit clear differences between tidal breathing and speech-related breathing, but categorically distinct breath support for syllable types with varying articulatory demands was not evident in the present findings. Speech development introduces increasingly complex utterances, so older infants may produce detectable articulation-related adaptations of breathing kinematics. For younger infants, breath support may vary systematically among utterance types, due more to phonatory variations than to articulatory demands.

Allied healthcare providers' role in screening for autism spectrum disorders.

There is evidence documenting that children are not being diagnosed with autism spectrum disorder (ASD) early enough. This study surveyed allied healthcare providers to determine whether these professionals had received training on the characteristics of ASD and ASD-specific screening strategies through their pre-professional education or continuing education (CE). Additionally, participants were asked about their responsibility for screening children for ASD in their workplace and what would help them be better prepared to perform this type of screening. As a group, speech-language pathologists (SLPs) and occupational therapists (OTs) reported receiving more training on the characteristics of ASD and screening for ASD in both their pre-professional education and CE workshops than reported by the physical therapists (PTs) and physicians assistants (PAs). Overall, the SLPS, OTs, and PTs had attended more CE trainings to gain information on ASD than had PAs. All groups expressed an interest in receiving more information on ASD via on- or off-site trainings. These results provide initial support for allied healthcare providers to become more active in screening and referring children who present with symptoms of ASD. The study also highlights the need for educational institutions to provide future healthcare professionals with the skills to provide appropriate early identification services for children and families.