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| Jane McCormack receiving the Menzies Foundation Allied Health Scholarship |
Her abstract is as follows:
"Communication impairment is a high prevalence condition in preschool children, and speech impairment (also called articulation/phonological/speech sound disorder) is one of the most common forms of communication impairment among this age group. Early intervention is recommended for children with speech impairment due to growing awareness of the potential long-term consequences of unresolved speech impairment (e.g., poorer school achievement, unemployment).
Intervention for speech impairment has traditionally focused on correcting children’s production of sounds/words, which may not address the full impact of speech impairment on a child’s life, or the priorities of the child and family. In recent years there has been a shift to consider health (including communication) in a more holistic manner, with the development of the International Classification of Functioning, Disability and Health (ICF; World Health Organization (WHO), 2001) and the ICF-Children and Youth version (ICF-CY; WHO, 2007). There has also been a shift to incorporate the views of clients (children and adults) in health intervention. In particular, the United Nations Convention on the Rights of the Child (UNCROC; UNICEF, 1989) stipulated the rights of children to express their views in all matters affecting them. Both the ICF-CY and the UNCROC have been recommended by speech-language pathology professional associations as important considerations to guide speech-language pathology research and practice.
To date, no studies have investigated the views of individuals with speech impairment regarding their experience of the impairment and the association between the impairment and limitations to life activities. The research undertaken through this doctoral research aimed to develop an understanding of childhood speech impairment as perceived by those who experience speech impairment and their communication partners. Specifically, the research aimed to fulfil two objectives: 1) to investigate the link between childhood speech impairment and limitations to life activities, and 2) to describe the experience of living with childhood speech impairment. In order to fulfil these objectives, a series of reviews and research studies were conducted, the results of which have been published (or submitted for publication) in Australia and internationally.
This doctoral research contains nine papers which present the reviews and research studies. The three review papers provide information about: (1) the prevalence of communication impairment in Australian children, (2) the theoretical framework used to guide the research (the ICF and ICF-CY), and (3) the application of the ICF-CY to children with speech impairment. The six subsequent research papers have unique aims and methodologies; however, all use the ICF and ICF-CY as a theoretical lens to provide an overarching perspective.
The first three research papers investigate the link between speech impairment and limitations to life activities: (1) a systematic review of 57 research studies, (2) analysis of parents’ (n=86) and SLPs’ (n=205) responses to questionnaires about the impact of speech impairment on life activities and participation, and (3) analysis of child, parent and teacher reports gathered (and made available to the researcher) in the nationally representative Longitudinal Study of Australian Children (n=4,329). In these three research studies, activities limited by speech impairment extend beyond communication-based activities, and include interpersonal interactions (e.g., relating to persons in authority, informal relationships with friends/peers, parent-child relationships, sibling relationships), learning activities (reading, writing, attention and thinking, calculating), and handling stress and other psychosocial demands. Furthermore, the difficulties associated with childhood speech impairment extend beyond early childhood into the school years and later.
The experience of living with childhood speech impairment is investigated through three additional research studies: (1) a meaning-making analysis of children’s drawings (n=13), (2) a phenomenological analysis of interviews conducted with preschool children (n=13) and their families (n=21), and (3) a phenomenological analysis of two young adults with a history of childhood speech impairment and their mothers. Again, difficulty with speech is not the only difficulty identified, nor is it always the priority for intervention. Children and their families recognise difficulties with communication relate to the speech skills of the child, but also to the ability of communication partners to understand the child’s message, and frustration resulting from communication breakdowns. Individuals with speech impairment and their mothers reveal the difficulties associated with speech impairment continue throughout the lifespan, affecting social interactions, academic skills, and career progression for individuals and causing distress, isolation or guilt for parents.
This doctoral research expands current understanding of the extent and experience of childhood speech impairment across the lifespan, and reveals the unique and valuable insights about speech impairment that children and their families provide. As a series of papers, this research forms a body of evidence that could be drawn upon by policy-makers, speech-language pathologists, and educators to provide direction for timely and holistic intervention services for individuals with speech impairment and their families."
