Designs and decisions: The creation and use of informal measures for assessing speech production in children

The following manuscript has been accepted for publication

Limbrick, N., McCormack, J., & McLeod, S. (2013, in press January). Designs and decisions: The creation and use of informal measures for assessing speech production in children. International Journal of Speech-Language Pathology.

ABSTRACT
Speech-language pathologists (SLPs) frequently assess children’s speech to diagnose and identify areas of difficulty, then determine appropriate intervention goals. Formal measures are available for assessment; however, many SLPs use informal measures within clinical practice. The purpose of this two-part mixed methods study was to describe informal measures created to assess children’s speech. Study 1 involved a systematic review of 39 informal measures identified via journal database and internet searches, scanning of reference lists, and submission by SLPs and researchers. The measures were reviewed in terms of their conceptualisation (content and format) and operationalisation (evaluation and validation). Common conceptual features included assessment of consonant singletons, single words, computer format, and picture-naming. Few measures provided information addressing operational criteria; in particular, they lacked evaluation of their effectiveness. Study 2 involved an inductive thematic analysis of journal entries from eight creators of informal measures that explored key considerations in the development process. Informal measures were created due to the absence of measures which were sufficiently comprehensive and culturally appropriate, plus a desire to incorporate technology. Considerations in the creation of informal measures included sourcing research and existing measures to inform the measures’ development, maximising children’s engagement, and utility. SLPs must be cautious when using informal measures due to their lack of operationalisation. However, these measures often address SLPs’ needs and so operationalisation of informal measures would be beneficial for the profession.

Construct validity of the FOCUS: A functional communication outcome measure for preschool children

The following manuscript has been accepted for publication within a special issue on Participation:

Washington, K. Thomas-Stonell, N., Oddson, B., McLeod, S., Warr-Leeper, G., & Robertson, B., & Rosenbaum, P. (2013, in press January). Construct validity of the FOCUS© (Focus on the Outcomes of Communication Under Six): A functional communication outcome measure for preschool children. Child: Care, Health and Development

Here is the abstract:  

Objective To establish the construct validity of the Focus on the Outcomes of Communication Under Six (FOCUS_©). This measure is reflective of concepts in the International Classification of Functioning Disability and Health – Children and Youth framework. It was developed to capture “real-world” changes (e.g., communicative participation) in preschoolers’ communication following speech-language intervention.

 Method A pre-post design was used. Fifty-two parents of 3- to 6-year-old preschoolers attending speech-language therapy were included as participants. Speech-language therapists provided individual and/or group intervention to preschoolers. Intervention targeted: articulation/phonology, voice/resonance, expressive/receptive language, play, and use of augmentative devices. Construct validity for communicative participation was assessed using pre-intervention and post-intervention parent interviews using the FOCUS_© and the communication and socialization domains of the Vineland Adaptive Behavior Scales-II (VABS-II). 

Results Significant associations were found between the FOCUS_©, measuring communicative participation, and the VABS-II domains for: (a) pre-intervention scores in communication, r=0.53, p<0.001; 95% CI=0.30-0.70 and socialization, r=0.67, p<0.001; 95% CI=0.48-0.80; (b) change scores over-time in communication, r=0.45, p<0.001; 95% CI =0.201-0.65 and socialization, r=0.39, p=0.002; 95% CI=0.13-0.60, and (c) scores at post-intervention for communication, r=0.53, p<0.001; 95% CI=0.30-0.70 and for socialization, r=0.37, p=0.003; 95% CI=0.11-0.50. 

Conclusions The study provided evidence on construct validity of the FOCUS_© for evaluating real-world changes in communication. We believe that the FOCUS_© is a useful measure of communicative participation.

The World Report on Disability and people with communication disability

The International Journal of Speech-Language Pathology has published a scientific forum titled: World Report on Disability and People with Communication Disability.
The issue can be found here: http://informahealthcare.com/toc/asl/15/1

The issue contains papers about people in Australia, Bolivia, Brazil, Ghana, India, Malaysia, Togo, South Africa, UK, Uganda, US, and VietNam and addresses many issues about underserved populations (including migrants and Indigenous people). The final paper by McAllister et al. summarizes all of the response papers and recommends a way forward for working with people with communication disability throughout the world. I thank Karen Wylie (Ghana), Lindy McAllister (Australia), Bronwyn Davidson (Australia), and Julie Marshall (UK) for their vision for this special issue, and for their hard work in pulling it together.
The contents are as follow

Lead article
Changing practice: Implications of the World Report on Disability for responding to communication disability in underserved populations

Karen Wylie, Lindy McAllister, Bronwyn Davidson, and Julie Marshall

Commentaries

Widening the SLP lens: How can we improve the wellbeing of people with communication disabilities globally?

Mary Wickenden                                                               

The World Report on Disability and communication disability: Some considerations from an Indian context

Juliet Goldbart and Reena Sen

Defining communication disability in underserved communities in response to the World Report on Disability

Sue Roulstone and Sam Harding

A perspective from Bolivia on the implications of the World Report on Disability for people with communication disabilities

Susan Buell

Addressing education of speech-language pathologists in the World Report on Disability: Development of a speech-language pathology program in Malaysia

Kartini Ahmad, Hasherah Ibrahim, Basyariatul Fathi Othman, and Etain Vong

The World Report on Disability in relation to the development of speech-language pathology in Viet Nam

Marie Atherton, Nguyễn Thị Ngọc Dung, and Võ Hoàng Nhân 

Implementation of the World Report on Disability: Developing human resource capacity to meet the needs of people with communication disability in Uganda

Helen Barrett and Julie Marshall

Collaborations to address barriers for people with communication disabilities in Ghana: Considering the World Report on Disability

Catherine Crowley, Miriam Baigorri, Clement Ntim, Belinda Bukari, Albert Oseibagyina, Emmanuel Kitcher, Albert Paintsil, Opoku Ware Ampomah, and Anthony Laing

A French-speaking speech-language pathology program in West Africa: Transfer of training between Minority and Majority World countries

Sylvia Topouzkhanian and Moustafa Mijiyawa

Knowledge transfer between Minority and Majority World settings and its application to the World Report on Disability

Li-Rong Lilly Cheng

Responding to the World Report on Disability in Australia: Lessons from collaboration in an urban Aboriginal and Torres Strait Islander school

Bronwyn Davidson, Anne E. Hill, and Alison Nelson

Involving people with communication disability in research in Uganda:  A response to the World Report on Disability

Isla Jones, Julie Marshall, Rebecca Lawthom, and Jennifer Read

Can the subaltern speak? Visibility of international migrants with communication and swallowing disabilities in the World Report on Disability

Mershen Pillay

Promoting change through political consciousness: A South African speech-language pathology response to the World Report on Disability

Harsha Kathard and Mershen Pillay

Implementing the World Report on Disability in Malaysia: A student-led service promoting knowledge and innovation

Sandra Van Dort, Julia Coyle, Linda Wilson, and Hasherah Mohd Ibrahim

Implementing recommendations of the World Report on Disability for indigenous populations

Carol Westby

“From your own thinking you can’t help us”: Intercultural collaboration to address inequities in services for Indigenous Australians in response to the World Report on Disability

Anne Lowell

The World Report on Disability as a blueprint for international, national, and local aphasia services

Linda E. Worrall, Tami Howe, Anna O’Callaghan, Anne J. Hill, Miranda Rose, Sarah J. Wallace, Tanya Rose, Kyla Brown, Emma Power, Robyn O’Halloran, and Alexia Rohde

Implications of the World Report on Disability for responding to communication disorders in Brazil

Fernanda Dreux M. Fernandes and Mara Behlau

Response
The World Report on Disability: An impetus to reconceptualise services for people with communication disability

Lindy McAllister, Karen Wylie, Bronwyn Davidson, and Julie Marshall

Images of Jamaica

What a pleasure it has been to visit Jamaica. Here are some images of this colourful island nation. I have enjoyed meeting the people of Jamaica, and exploring its beauty.

Dunn's River Falls

Boats at Port Royal

Seven Mile Beach

Jamaican boys aged 4 and 6 (used with permission)

Invited lecture: The importance of supporting children’s speech and language development

Today I presented an invited lecture titled: "The importance of supporting children's speech and language development" to the pediatricians and registrars in the Faculty of Medicine at the University of the West Indies, Mona Campus, Kingston, Jamaica. During the lecture I covered the prevalence, risk, and impact of speech and language impairment within the framework of the International Classification of Functioning Disability and Health (World Health Organization, 2001, 2007). I also described the research we were undertaking in Jamaica, and summarized what is known about multilingual speech and language acquisition.

Professors and paediatric registrars at the lecture

Learning from the children of Jamaica

Karla and Sharynne

The main purpose of our visit to Jamaica has been to document young Jamaican children's speech and language skills. Dr Karla Washington (University of Cincinnati, USA) and I have been assessing 3- to 6-year-old children's speech and language skills. During the two hour assessments the children complete activities with Karla in Jamaican Patois (Jamiekan) and with me in English. One of the research aims is to document these young children's ability to code-switch between the two languages. We have used the International Classification of Functioning Disability and Health as the framework for our research so are also incorporating measures to consider the whole child. The children arrive at school at 7:30am and although school finishes at 1:30pm, some do not leave until after 4pm when their parents are finished work, so we have been able to work with the children throughout the day. It has been such a pleasure to spend time with and learn from these wonderful children.

A language assessment in Jamaican

A speech assessment in English

The children drew themselves talking

Supporting Jamaican children's early development

Dr Karla Washington and I have had the pleasure of working with Professor Maureen Samms-Vaughan while in Jamaica. Professor Samms-Vaughan is the Professor of Child Health, Child Development and Behaviour at the University of the West Indies. She is also the chairman of the board of the Early Childhood Commission. She is a strong advocate of supporting children in early childhood, and also supporting their speech and language acquisition. She has been conducting large scale longitudinal studies of Jamaican children for many years. Her second birth cohort study began in 2011 (see photo). She is also conducting important research into the identification of autism in Jamaican children. We attended a lecture at the University of the West Indies presented by Professor Samms-Vaughan and her colleagues.

Dr Karla Washington, Professor Maureen Samms-Vaughan, and Sharynne

Considerations when testing Jamaican children's speech

Over the next few weeks Dr Karla Washington and I will be testing Jamaican children's speech and language. We have been talking with Professor Hubert Devonish and other Jamaican people about the suitability of different commercially available tests for Jamaican children. We plan to use the Diagnostic Evaluation of Articulation and Phonology (DEAP, Dodd et al., 2006) as a speech assessment. Here are a few of the items that may not be known by Jamaican children:

• Thumb = Big finger
• Leg = Foot
• Sock = One foot a sock OR a socks (whereas socks = socks)
• Gloves = Who needs gloves in Jamaica - you swim at the beach in winter!
• Apple = Jamaican apples are red and shaped like pears (not round green ones like in the DEAP)
• Orange = May not be known because oranges have greenish skins (while orange inside)
• Strawberry = May not be known

Words and images that are better known are pictured below

Breadfruit and ackee

Fried fish, festival, and bammy (Jamaican fish and chips)

One style of Jamaican house (a little more colourful than the DEAP picture!)

A further consideration is the dress code when visiting schools.Below is a notice from one of the schools in Jamaica about the appropriate dress code for visitors. I have found that in many countries that I have visited I have been asked to wear "church clothes" when working in schools and universities (e.g., dresses with sleeves and shoes with closed toes).

The Jamaican Language Unit (Di Jamiekan Langwij Yuunit)

Dr Karla Washington, Professor Hubert Devonish,
and Sharynne holding the Jamaican New Testament and How to Write Jamaican

Today Dr Karla Washington (University of Cincinnati) and I visited Di Jamiekan Langwij Yuunit (The Jamaican Language Unit). The Unit was established in 2002 by the Jamaican government to recognize and support the use of the Jamaican language.

Professor Hubert Devonish is the head of the Unit, and is a distinguished linguist and scholar in the area of Caribbean languages. His most recent project has been to provide advice for the translation of the New Testament (Bible) into Jamaican. He also has written "Writing Jamaican the Jamaican Way/Ou fi Rait Jamiekan". The book uses the Cassidy-JLU writing system that is based on a phonetic realisation of spoken Jamiekan. The Jamiekan alphabet contains the following letters and letter combinations: a, aa, ai, b, ch, d, e, f, g, hn, I, ie, ii, j, k, l, m, n, ng, o, ou, p, r, s, sh, t, u, uo, uu, v, w, y, z, zh.

Professor Devonish provided us with valuable advice about the various phonetic and phonemic transcriptions of words pronounced by Jamaican adults. We will use these as the range of possible adult targets for our research with the Jamaican children next week.

University of the West Indies

Today Karla and I visited the University of the West Indies (UWI) Mona Campus and were given a tour by professor Hubert Devonish. UWI has three physical campuses: Mona (Jamaica), St. Augustine (Trinidad and Tobago), Cave Hill (Barbados) and an Open Campus. It serves 19 countries in the Caribbean. The Mona Campus is on the site of two plantations, and the aqueducts used to drive the mills are still able to be seen. The brown pelican is on the coat of arms. The Jamaican Language Unit is housed at UWI.

Aqueducts

Dr Karla Washington and Professor Hubert Devonish beside the Communication mural

The interior of the UWI chapel

Jamiekan

Jamiekan, also known as Jamaican Creole, Patwa (or Patois) is spoken by many Jamaicans. Jamaicans are said to be diglossic, that is, they speak both Jamiekan and English along a continuum, depending on the communicative and social situation. Jamiekan contains words from English, West African, and French languages (Cassidy, 1966). In 2001, the Parliament of Jamaica created a Charter of Rights that included protection from discrimination on the basis of language use and recommended recognition of two co-existing language varieties in Jamaica. The Jamaican Language Unit (Di Jamiekan Langwij Yuunit) took effect in September 2002 as a language planning agency to foster the use of Jamiekan.

Jamiekan phonology consists of 33 different phonemes, comprising 21 consonants and 12 vowels (five short vowels, three long vowels, and four diphthongs) (Devonish & Harry, 2004; Harry, 2006). Phonological rules common to Jamiekan include: /h/ deletion or insertion, palatalization of plosives, obstruent neutralization, obstruent weakening, and labialization (Harry, 2006).

Information based on:

Washington, K. N. (2012). Translation to practice: Typical bidialectal speech acquisition in Jamaica. In S. McLeod & B. A. Goldstein (Eds.), Multilingual aspects of speech sound disorders in children (pp. 101-105). Bristol, UK: Multilingual Matters.

References:

Cassidy, F. G. (1966). Multiple etymologies in Jamaican creole. American Speech, 41(3), 211-215. 
Devonish, H., & Harry, O. G. (2004). Jamaican phonology. In B. Kortman, & E. W. Shneider, (Eds.). A handbook of varieties of English, vol 1: Phonology, (pp. 441-471). Berlin: Moton De Gruyter. 
Harry, O. G. (2006). Jamaican creole. Journal of the International Phonetic Association, 36(1), 125-131.

The impact of extrinsic demographic factors on Cantonese speech sound acquisition

The following manuscript has been accepted for publication:

To, C. K. -S., Cheung, P. S. -P., & McLeod, S. (2013, in press January). The impact of extrinsic demographic factors on Cantonese speech sound acquisition. Clinical Linguistics and Phonetics.

ABSTRACT
Aims: This study modeled the associations between extrinsic demographic factors and children’s speech acquisition in Hong Kong Cantonese.
Method & Procedure: The speech of 937 Cantonese-speaking children aged 2;4 to 6;7 in Hong Kong was assessed using a standardized speech test. Demographic information regarding household income, paternal education, maternal education, presence of siblings, and having a domestic helper as the main caregiver was collected via parent questionnaires.
Outcomes & Results: After controlling for age and sex, higher maternal education and higher household income were significantly associated with better speech skills; however, these variables explained a negligible amount of variance. Paternal education, number of siblings, and having a foreign domestic helper did not associate with a child’s speech acquisition.
Conclusions & Implications: Extrinsic factors only exerted minimal influence on children’s speech acquisition. A large amount of unexplained variance in speech ability still warrants further research.


PUBLISHED (May, 2013):
To, C. K. S., Cheung, P. S. P., & McLeod, S. (2013). The impact of extrinsic demographic factors on Cantonese speech acquisition. Clinical Linguistics and Phonetics, 27(5), 323-338. doi:10.3109/02699206.2013.763385