Rapid transition to telepractice across the lifespan in speech-language pathology: Insight from a survey of clinicians in Canada.

PURPOSE: This study aims to describe the experiences and needs of Canadian speech-language pathologists (SLPs) who conducted communication assessments via telepractice across the lifespan during the first year (2020) of the COVID-19 pandemic. METHOD: The present study consisted of an online survey that aimed to capture both quantitative aspects of telepractice-based communication assessment and the qualitative experience of shifting to telepractice. One hundred sixty-eight practicing SLPs across Canada participated in the survey, between September 2020 and January 2021. Quantitative results were analysed using descriptive statistics while open-ended responses were analysed using thematic analysis. RESULT: SLPs identified challenges and opportunities relating to client and family engagement, access to and knowledge of technology, and the reliability of assessment tools. SLPs also identified a future need for online assessment materials and training, such as materials adapted for different communication needs (e.g. augmentative and alternative communication). CONCLUSION: The present study contributes to a growing understanding worldwide of potential benefits and challenges related to telepractice, fuelled by the necessary shift in practices in our field during the COVID-19 pandemic. The results provide direction for continuing to build a valid and inclusive approach to telepractice in the future.

Properties of Lexical Diversity in the Narratives of Children With Typical Language Development and Developmental Language Disorder.

Purpose We examined four measures of lexical diversity in the narratives of children with typical language development (TLD) and developmental language disorder (DLD) that comprised the normative sample of the Edmonton Narrative Norms Instrument (Schneider et al., 2005). The purpose was to document the properties of each measure with respect to variations in utterance and sample length, developmental trends, and group differences. Method The sample consisted of 377 picture-elicited, story generation transcripts from children with TLD (n = 300) and DLD (n = 77) aged 4-9 years. We extracted the moving-average type-token ratio (MATTR) and the number of different words from the full sample, from samples equated for the number of utterances, and from samples equated for the total number of words. Results MATTR was the only measure to show no relationships to utterance or sample length. All measures showed significant positive growth with age and significant groupwise differences between children with TLD and DLD. However, the magnitude of age effects and differentiation between groups varied considerably across measures. Across measures, there were significant differences in the number of children with DLD who were identified with low lexical diversity relative to their same-age peers in the TLD group. Conclusion The results of this study support the view that different measures of lexical diversity may be appropriate for different clinical purposes. It is important for clinicians to understand how measures of lexical diversity function in order to make educated choices among measures and ensure appropriate interpretation.

Lexical Diversity Versus Lexical Error in the Language Transcripts of Children With Developmental Language Disorder: Different Conclusions About Lexical Ability.

Purpose The purpose of this study was to provide preliminary data on differences in lexical diversity and lexical-semantic errors in the language samples of children with developmental language disorder (DLD) and children with typical language development (TLD) of the same age. Method We analyzed word use in the narrative transcripts of children with DLD and TLD (N = 14; M age = 6;8 [years;months]) using standard measures of lexical diversity (number of different words, moving-average type-token ratio) and additional counts of lexical-semantic errors. Results There were no significant differences between the groups in lexical diversity, and all children with DLD scored within the age-appropriate range on diversity relative to a normative sample. The children with DLD, however, produced significantly more lexical errors than their TLD peers. Conclusions The results suggest that caution is warranted when interpreting normal-range lexical diversity scores in children with DLD, as children with DLD may demonstrate functional difficulties with word use that are not captured by lexical diversity measures. A focus on lexical errors holds promise for characterizing lexical-semantic qualities of language transcripts that are not captured by standard measures of diversity. Development of a reliable clinical system for coding and characterizing lexical-semantic errors in language transcripts is warranted.

Congruence in Research Question, Design, and Analysis: A Tutorial on the Measurement of Change in Clinical Speech and Language Research.

Purpose Measuring change is a common goal in clinical research, and comparing nonequivalent groups is sometimes a necessity in this context. Yet, evaluating change in this way can be problematic, and little consensus is reported on the best way to conduct such an evaluation. This tutorial presents the process of planning a clinical study designed to measure change in the context of a therapeutic intervention. Method This article presents a hypothetical clinical research scenario and follows the process of study design from question formulation to interpretation of results. The presentation focuses on the use of gain score analysis in the context of nonequivalent participant groups, methods that may be particularly relevant to the clinical context. Conditions that are favorable to gain score use, as well as situations that are problematic for gain score use, are presented. Conclusions In this article, the clinical research process is presented, following a logical process from formulation of a clear research question to selection of an appropriate research design to implementation of an effective analysis method. Gain score analysis is presented as an effective tool to measure change in clinical research, even with nonequivalent groups, given the correct conditions.