Exploring Speech-Language Pathologists' Perception of and Individualized Education Program Goals for Vocabulary Intervention With School-Age Children With Language Disorders.

PURPOSE: Among the varied roles and responsibilities of school-based speech-language pathologists (SLPs) are the planning and delivery of effective vocabulary intervention for students with language disorders. Despite the abundant literature regarding effective vocabulary intervention, practice patterns indicate that the research has not yet translated to practice. The purpose of this study was to examine SLPs' beliefs and expectations regarding vocabulary instruction and the content of Individualized Education Program (IEP) goals to better inform continuing education and research programs to generate lasting effects on SLP practices. METHOD: We queried a national sample of school-based SLPs via an online survey regarding their perspectives on robust vocabulary instruction, vocabulary intervention practices, and IEP goal development targeting vocabulary skills for school-age children with language disorders. RESULTS: There was consistency across the sample for SLPs' beliefs about the importance and impact of robust vocabulary instruction. However, they reflected varied expectations about the vocabulary intervention they provide. Qualitative analysis of IEP goals for vocabulary reveals the range and frequency of strategies and intervention targets as an artifact of implementation of robust vocabulary instruction. CONCLUSIONS: School-based SLPs believe that vocabulary is important and have a strong understanding of the impact robust vocabulary instruction can have on reading and writing outcomes. SLPs in this sample had varying expectations regarding the way their instruction is implemented and generalized. Implications and limitations of these results are discussed. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25077992.

Like, Comment, and Share: Speech-Language Pathologists' Use of Social Media for Clinical Decision Making.

Many social media sites are dedicated for speech-language pathologists (SLPs); however, the extent to which SLPs utilize them in clinical decision making and evidence-based practice (EBP) is not well understood. The purpose of this study was to explore SLPs' use of traditional and modern resources, including social media, within clinical decision making for assessment and intervention practices. Using a stratified random sampling approach, we invited school-based SLPs in Florida and Ohio and on pediatric-focused, SLP Facebook sites to complete an online survey. The majority (N = 271) reported using social media for professional purposes at least once per week: most frequently Facebook (19-25% of SLPs) or Pinterest (15-18% of SLPs) to learn about new treatment ideas or resources for (12-18%) or read others' summaries of treatment-related research (8-11%), but rarely to pose or answer a clinical question (3-5%). The number of reasons for one's professional social media use was moderately correlated with frequency of social media use, traditional EBP training, and reading a greater number of articles from ASHA and other sources. The results warrant further consideration of how to leverage social media as a tool to increase SLPs' knowledge and implementation of EBP.

School-Based Speech-Language Pathologists' Engagement With Evidence-Based Practice: An Update With Implications for Implementation Research.

PURPOSE: We replicated a prior survey study (Hoffman et al., 2013) to document current evidence-based practice (EBP) patterns as reported by school-based speech-language pathologists (SLPs) during the 2021-2022 school year. METHOD: Via an online survey, SLPs reported their training experiences and needs, workplace resources, and frequency of engagement in EBP activities. RESULTS: A total of 889 SLPs in 50 states participated in the survey. Results revealed that 19% of seasoned SLPs (with more than 10 years since last degree) had no formal training in EBP, 22% of SLPs worked in school districts with official EBP procedural guidelines, and 36% had scheduled time in their work week to support EBP activities. Early career (EC) professionals were more likely than seasoned career (SC) professionals to pose and research one or more EBP questions per year and to read journal articles about assessment and treatment. The gap in article use by experience groups was larger than a decade ago. Like prior survey results, the majority of SLPs read zero to four American Speech-Language-Hearing Association (ASHA) journal articles on assessment or intervention per year, with similar results for reading non-ASHA journal articles. CONCLUSIONS: Although the past decade has fostered some positive increases in the use of EBP resources and engagement in EBP activities, there continues to be a need for additional training and support for school-based SLPs to fully implement EBP. Training and implementation support should account for differences in training preferences and workplace resources and address differentiation of reported practices by EC versus SC professionals. Further implications for implementation science in schools are provided. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.23152817.

An examination of 3rd and 5th grade students' use of dialect specific forms during a written editing task.

PURPOSE: The goal of the current study was to examine the role of variety and frequency of dialectal features in relation to General American English (GAE) editing ability. This study focused on speakers of dialect-specific forms and their ability to edit to GAE. To gain insight into this relation, the following research questions were posed: (1). How do third and fifth-grade students differ in the variety of features of dialect-specific forms they use, the frequency of their use, and their editing ability to GAE? (2). Is there a significant relation between dialect use and editing ability? METHODS: Participants included 68 third and fifth-grade students who produced at least one dialect-specific form. We measured students' ability to edit to GAE during a written editing task. Frequency and variety of dialect use were based on an oral language sample where students were asked to share their favorite game or sport. RESULTS: Fifth-grade students are significantly better at editing written dialect specific forms to reflect GAE writing conventions as compared to third-grade students. However, there was not a significant difference in the dialect specific form usage between the two grades. Finally, there was not a significant relation between dialect specific form use and editing ability. CONCLUSIONS: These results offer relevant clinical and educational implications for increasing cultural responsivity and promote the use of multiple measures across modalities to gain relevant information when assessing students who use dialect specific forms. Further, the results from this study provide further insights into how written editing ability exhibited through the awareness of GAE conventions improves with age despite the influence of dialect specific forms.

School-Based Speech-Language Pathologists' Stress and Burnout: A Cross-Sectional Survey at the Height of the COVID-19 Pandemic.

PURPOSE: Low retention of school-based speech-language pathologists (SLPs) is a growing problem that can have drastic consequences at the school and student levels. Factors contributing to this shortage include features of the work environment, role ambiguity, low salaries, and a demanding workload with higher caseloads, which can result in limited time for paperwork and lesson planning for optimal service delivery models. The purpose of this study was to determine the current levels and predictors of occupational stress and burnout SLPs are experiencing in the school setting. METHOD: Using a cross-sectional survey design, 453 school-based SLPs from across the United States reported their workload manageability, career intentions, access to social support, and their stress and burnout levels. Multiple linear regression was used to determine the relation between the variables of interest and the occupational stress and burnout scores. Data were collected in September to December of 2020, at the height of the COVID-19 pandemic. RESULTS: SLPs, on average, reported overall stress levels in the somewhat noticeable range, moderate access to social support, high levels of emotional exhaustion, low-to-moderate feelings of depersonalization, and moderate-to-high feelings of personal accomplishments. Based on a standardized burnout scale, SLPs in this sample are characterized as feeling ineffective and overextended. Results of linear regression models suggest that the perception of work manageability was the best predictor of Total Stress score, Emotional Exhaustion score, and Depersonalization score, in this sample. CONCLUSIONS: Data from this study offer the beginning steps to making an informed change for school-based SLPs' workplaces. Results indicated that SLPs in the school setting are feeling ineffective and overextended. The perception of their workload manageability was the most significant predictor for their reported stress and burnout levels. Suggestions for SLP supervisors, administrators, and other stakeholders are discussed.

Providing Telepractice in Schools During a Pandemic: The Experiences and Perspectives of Speech-Language Pathologists.

PURPOSE: The main objective of this study was to gain insight into school-based speech-language pathologists' (SLPs') perspectives on and experiences with telepractice as a service delivery model at the onset of the COVID-19 global pandemic. A better understanding of the facilitating and challenging factors that belie telepractice-based services will guide the creation of training and resource development to further support remote speech-language services in schools. METHOD: Four focus group sessions using a semistructured format were conducted with 22 school-based SLPs from 14 states in the United States. The focus groups provided an opportunity for SLPs to reflect on their telepractice experiences, including pros and cons, necessary knowledge and skills, factors impacting telepractice service delivery, and student and family participation. Inductive thematic analysis was used to describe the collective experiences and perspectives of the participants. RESULTS: Three themes regarding telepractice emerged: technology use, locus of control for decision making, and student and family engagement. Participants reported experiencing a range of successes and challenges when attempting to meet students' needs and identified gaps in resources and school capacity for telepractice. CONCLUSIONS: The findings revealed how school SLPs experienced telepractice service delivery during the remote learning portion of the 2019-2020 school year due to the onset of the COVID-19 pandemic. The study increases our understanding of factors that facilitated and challenged the effective delivery of speech-language services via telepractice. To assist SLPs in future telepractice efforts, implications for professional development and further research are provided.

A Comparison of the Prevalence Rates of Language Impairment Before and After Response-to-Intervention Implementation.

Purpose This research note presents a secondary data analysis of language impairment (LI) prevalence rates of children in public schools before and after a statewide mandate for response-to-intervention (RTI) implementation. Method Statewide and district-level LI prevalence rates were compared across 10 school years. Prevalence data from 67 school districts located in 1 state in the United States are reported as the proportion of the general student population (students ages 3-21 years) who were identified with a primary disability of LI. Results The mandated implementation of RTI within special education prereferral, evaluation, and eligibility processes coincided with significant changes in LI prevalence as a primary disability for most of the school districts. The majority of school districts experienced an increase in LI prevalence within 1 school year following RTI implementation. However, the degree and direction of change in prevalence rates varied across some of the school districts. Similar degrees of change were not evident across the other years of prevalence data review, suggesting the systemic change that occurred via RTI requirements coincided with fluctuations in the LI prevalence rates for the majority of school districts in the state. Conclusion A causal relation between RTI and LI prevalence cannot be established with the current data; however, this study establishes a temporal connection between the timing of RTI implementation and changes in LI prevalence in public schools of 1 very large state. Implications are presented for further research investigating the potential impact of systemic mandates on the identification of school-age children with LI. Supplemental Material https://doi.org/10.23641/asha.8968676.

Adolescents' production of complex syntax in spoken and written expository and persuasive genres.

Analysing spoken and written language samples across different genres provides speech-language pathologists (SLPs) and educators with information about adolescents' production of complex syntax, an important socially and academically related language skill. However, researchers report that production of complex syntax is affected by genre and modality. Although the narrative and expository genres elicit a greater amount of complex syntax than conversational discourse, it is unknown whether differences in production of complex syntax exist between the persuasive and expository genres. The purpose of this study was to compare adolescents' production of complex syntax across spoken and written expository and persuasive genres. Spoken and written expository and persuasive language samples were elicited from 64 adolescents. Complex syntax was measured by calculating per cent of complex utterances and clausal density. Two repeated measures ANOVA revealed that complex syntax production was affected by genre and modality. Adolescents produced a higher percent of complex utterances and a higher clausal density in the persuasive genre than the expository genre. Adolescents produced a higher percent of complex utterances in the written modality than the spoken modality across genres; however, there was not a significant difference in adolescents' clausal density across modalities. There were significant interaction effects between genre and modality for percent of complex utterances and clausal density. The significant interaction effects suggest that differences in the production of complex syntax between the spoken and written modalities depended on the genre elicited. We discuss multiple implications and specific directions for future research.

Innovative Models of Dental Care Delivery and Coverage: Patient-Centric Dental Benefits Based on Digital Oral Health Risk Assessment.

Innovative models of dental care delivery and coverage are emerging across oral health care systems causing changes to treatment and benefit plans. A novel addition to these models is digital risk assessment, which offers a promising new approach that incorporates the use of a cloud-based technology platform to assess an individual patient's risk for oral disease. Risk assessment changes treatment by including risk as a modifier of treatment and as a determinant of preventive services. Benefit plans are being developed to use risk assessment to predetermine preventive benefits for patients identified at elevated risk for oral disease.

Linguistic Feature Development Across Grades and Genre in Elementary Writing.

PURPOSE: As children develop skills in writing across academic contexts, clinicians and educators need to have a fundamental understanding of typical writing development as well as valid and reliable assessment methods. The purpose of this study was to examine the progression of linguistic elements in school-age children's narrative and expository writing development. METHOD: Narrative and expository writing samples produced by 89 children in Grades 2 through 4 were analyzed at the microstructure and macrostructure levels. Measures of receptive vocabulary, word-level reading, and reading comprehension were obtained. RESULTS: Exploratory factor analyses revealed 4 microstructure factors (e.g., productivity, grammatical complexity, grammatical accuracy, and lexical density) and 1 macrostructure factor (e.g., a combination of organization, text structure, and cohesion). Multivariate analyses of covariance with reading comprehension as a covariate showed that productivity and macrostructure were sensitive to grade-level and genre differences and that expository grammatical complexity was sensitive to grade-level differences. CONCLUSIONS: Findings are discussed in light of grade-level standards for narrative and expository writing and current practices in writing assessment. Multiple suggestions are offered for clinical and educational implications, and specific directions are provided for future research.

Evidence-based speech-language pathology practices in schools: findings from a national survey.

PURPOSE: This study documented evidence-based practice (EBP) patterns as reported by speech-language pathologists (SLPs) employed in public schools during 2010-2011. METHOD: Using an online survey, practioners reported their EBP training experiences, resources available in their workplaces, and the frequency with which they engage in specific EBP activities, as well as their resource needs and future training format preferences. RESULTS: A total of 2,762 SLPs in 28 states participated in the online survey, 85% of whom reported holding the Certificate of Clinical Competence in Speech-Language Pathology credential. Results revealed that one quarter of survey respondents had no formal training in EBP, 11% of SLPs worked in school districts with official EBP procedural guidelines, and 91% had no scheduled time to support EBP activities. The majority of SLPs posed and researched 0 to 2 EBP questions per year and read 0 to 4 American Speech-Language-Hearing Association (ASHA) journal articles per year on either assessment or intervention topics. CONCLUSION: Use of ASHA online resources and engagement in EBP activities were documented to be low. However, results also revealed that school-based SLPs have high interest in additional training and resources to support scientifically based practices. Suggestions for enhancing EBP support in public schools and augmenting knowledge transfer are provided.

Check a Box. Save a Life: How student leadership is shaking up health care and driving a revolution in patient safety.

OBJECTIVES: The objective was to engage health professions students as leaders in spreading the World Health Organization Surgical Checklist. The published impact of the checklist in reducing surgical complications and deaths, combined with its ease of use, offers an ideal target for students to save lives and prevent suffering. As members of the "Check a Box. Save a Life." campaign, students can speed the pace of patient safety improvement. METHODS: The campaign was developed around an online Webcast event, designated its launch. Outreach was conducted mainly through social media, especially the popular networking Web site, Facebook. The Institute for Healthcare Improvement's Open School for Health Professions and the American Medical Student Association provided a source of potential campaign members. RESULTS: One hundred eighty-two registrants, representing 122 distinct hosting institutions, signed up for the launch event. Based on hosts' projected event sizes, assessed in a registration questionnaire, approximately 1400 students are believed to have participated in the event. After the launch, these students joined the campaign and were invited to carry out projects in their home institutions. Six weeks after the launch, the campaign reconvened at the Institute for Healthcare Improvement's 21st Annual National Forum, and attendees presented case reports of 15 projects they had undertaken since the launch. CONCLUSIONS: As an independent, self-organized, decentralized effort and an application of student social organizing to the cause of patient safety, "Check a Box." is a landmark achievement. Leveraging social media and disrupting the traditional model of safety leadership, the campaign offers hope for the future of patient safety.

Imminent adopters of electronic health records in ambulatory care.

BACKGROUND: Although evidence suggests electronic health records (EHRs) can improve quality and efficiency, provider adoption rates in the US ambulatory setting are relatively low. Prior studies have identified factors correlated with EHR use, but less is known about characteristics of physicians on the verge of adoption. OBJECTIVE: To compare characteristics of physicians who are imminent adopters of EHRs with EHR users and non-users. DESIGN AND PARTICIPANTS: A survey was mailed (June - November 2005) to a stratified random sample of all medical practices in Massachusetts. One physician from each practice (n=1884) was randomly selected to participate. Overall, 1345 physicians (71.4%) responded to the survey, with 1082 eligible for analysis due to exclusion criteria. 'Imminent adopters' were those planning to adopt EHRs within 12 months. MEASUREMENTS: We assessed physician and practice characteristics, availability of technology, barriers to adoption or expansion of health information technology (HIT), computer proficiency, and financial considerations. RESULTS: Compared to non-users, imminent adopters were younger, more experienced with technology, and more often in practices engaged in quality improvement. More imminent adopters owned or partly owned their practices (57.4%) than users (33.5%; p<0.001), but fewer imminent adopters owned their practices than non-users (65.7%; p<0.001). Additionally, more imminent adopters (26.0%) reported personal financial incentives for HIT use than users (14.8%; p<0.001) and non-users (10.8%; p<0.001). CONCLUSIONS: Imminent adopters of EHRs differed from users and non-users. Financial considerations appear to play a major role in adoption decisions. Knowledge of these differences may assist policy-makers and healthcare leaders as they work to increase EHR adoption rates.

Providers' expectations of ambulatory electronic health records (EHRs).

Little is known about how providers expect the implementation of a new electronic health record (EHR) will affect their clinical workflow. We found that providers currently completing clinical tasks electronically are more satisfied with task completion than those completing similar tasks on paper. Yet, these already electronic providers expect less future satisfaction with the new EHR compared with paper-based providers. Further understanding of provider expectations can assist in optimally tailoring implementation plans.

Dental water quality--the scientific evidence for current CDC guidelines.

Newly revised and updated guidelines from the Centers for Disease Control and Prevention recommend adoption of procedures to improve the microbiological quality of water used in dental treatment. These recommendations represent the consensus of experts from a wide range of scientific and clinical disciplines and are based on the best currently available evidence. Dentists and the manufacturers of dental equipment must consider the infection control, occupational health and risk-management implications of biofilm colonization in dental equipment, and take appropriate measures to provide water of appropriate microbiological quality clinical procedures.